Tag: Autism

Water Park Fun

Posted on by Nicky

Water Park Fun 

with autism 

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water park fun

water park

Before the Water Park Fun

What a beautiful morning for some water park fun! Our mornings typical starts with waking up at 5:30 am to prepare breakfast before Liam gets up. Liam is an early morning kind of boy who does not like to wait too long for breakfast. He adheres to routine and maintains his school morning routines regardless of the day of week. Regardless of whether it is a school morning, weekend, or holiday.

Once he opens his eyes to dawn, he likes to wait in bed for about five to ten minutes before getting up to brush his teeth. He walks to the kitchen to confirm that breakfast is being made. I usually finish the breakfast preparation just in time to join him in the bathroom to monitor his teeth brushing technique and offer help should he need it. Then comes the high five’ as positive reinforcement for brushing his teeth properly. After brushing his teeth, he cleans up after himself. Then comes more high fives. He loves those proud ‘high five’ moment.

 

scrambled eggs

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Before we get into the water park fun, let’s discuss the breakfast of the day. Today’s breakfast is scrambled eggs, bread rolls, with our favorite beverages. That is, a cup of coffee for me and for Liam, Emergen-c mixed with water. On rare days he will enjoy hot chocolate. However, mostly he prefers the Emergen-c mixture with his breakfast. We drink Emergen-c every morning to avoid the common cold. 

Earlier I mentioned his adherence to routine? Guess what? His breakfast must be placed at the left of the breakfast bar. Think of the Sheldon character on the TV show, the Big Bang Theory. Though, unlike the Sheldon character who never changes his spot on his side of the couch, Liam may change his spot at the breakfast bar on a few occasions to have breakfast around the dinner table. 

Encourage to Participate

  • Chooses from a list of breakfast options
  • Participates in breakfast preparations 
  • Helps with cleanup

coffee beans

SUPER SWEET FUN DAY

Liam did not always enjoy variety of foods. In many ways he is still quite picky. For instance, he will not eat any green vegetables unless creatively hidden. Sometimes, he will try lettuce or kale, but that is with a lot of encouragement in the form of high fives. As for fruits, he will only eat bananas. He will try most things except vegetables and fruits. This is much improvement. 

In the past, he would only eat oatmeal and a specific meal replacement drink. His food aversions lasted up until he was five years old. Now he eats most things prepared, excluding unconcealed green vegetables. I usually allow him to have a say in his breakfast choices. Whenever his breakfast of choice involved eggs, he is encouraged to participate in the preparation. 

At the Water Park 

Liam had no idea he was headed for some waterpark fun. All he knew and cared about was that we were heading out somewhere; anywhere for all he cared. He loves the outdoors. We drove to three waterparks only to find that they were closed for maintenance. After calling and driving around, we finally found a park that was open for some waterpark fun. It was a small, cozy waterpark with limited guests. Staff was welcoming and friendly. They were also surprisingly sensory-friendly, a great aspect of the establishment.

We were screened before entering the waterpark. Staff met us at entrance to inform us of the park rules, and to ensure we had proper and adequate equipment for play and safety.

 

Liam had a great day splashing, swimming, and playing at the waterpark. He even met a new friend. Our waterpark fun lasted from 10.30 am until 1:30 pm. He had so much fun that it was nearly impossible to get him to leave. When we initially tried to leave, he protested. With compromise, we were able to leave with the promise of returning for more waterpark 

water park fun

waterpark

water park fun

What is Autism Spectrum Disorder

Posted on by Nicky

Autism Spectrum Disorder

So what is Autism? There is growing public awareness on autism spectrum disorder (ASD). Autism is a neurodevelopmental disorder characterized by limitations in communication, unusual social skills, and repetitious behaviors. The American psychiatric association (2013) further adds that autism spectrum disorder (ASD) is typified by stereotyped interests and activities. Hence, autism is considered a spectrum of disorders due to its wide array of characteristics.

 

autism spinner

autism crayons

Autism

Defining Autism

Boy with autism

Today, more Americans are being diagnosed with autism. The Centers for Disease Control and Prevention (CDC, 2019) reports that 1 in 59 children are diagnosed with autism.Also, the CDC reports that boys are four times more likely than girls to develop the disorder. This is a significant rise from the past  As a result of the increase in autism diagnosis, public interest is rising. The increase in public interest is leading to more investigative research on autism, its trend, medical complications and management.

 

What is Autism: Trends 

Toddler with autism

While there is no cause for Autism, research suggests that a combination of genetic and environmental factors increase the risk of developing ASD (Zuckerman, Lindly, & Sinche, 2016). Though genetic and environmental risk factors are major factors of ASD, preterm infants and certain socioeconomic groups are at greater risk.

 

Physical Presentation of Autism 

What is autism and what does it look like? Since autism spectrum disorder (ASD) is a neurodevelopmental disorder it is arbitrary to rely on physical features for a diagnosis. ASD does not carry an absolute physical symptom; however, research have pointed to some common traits shared among children with ASD. Examples of these traits are facial asymmetry, abnormal hair whorls, and infant head lag (Ozgen et al., 2013). Researchers also emphasize an increase in morphological features in children with the disorder.

Nonetheless, the link between facial asymmetry and autism spectrum disorder is weakened by counteracting studies that confirm facial asymmetry in more than half of the populace (Thiesen, Gribel, & Freitas, 2015). Due to limitations in current evidence, further research is needed to investigate the physical expressions of ASD.

 

Clinical Presentation of Autism 

Individuals with autism are among the vulnerable populations. Their various limitations and exceptions place them at increased risk of health inequality. So, to meet the healthcare needs of this vulnerable group, healthcare professionals must learn to recognize the varying clinical presentation of autism.

Proper identification of patients with ASD can promote appropriate treatment interventions.  For instance, a practitioner may notice gaze abnormalities, abnormal motor movement, attention deficit, or hyperactivity disorder in the patient with ASD (Grynszpan et al., 2012).

Children with ASD may be at increased vulnerability to immunologic disorders, seizure disorders, and neuropsychiatric illnesses (Salpekar, 2018). Therefore optimal health outcome depends on parents, caregivers, and healthcare professionals’ collaboration in the immediate recognition of the signs of sickness. Therefore it is recommended that healthcare providers adopt an autism spectrum disorder screening tool routinely in their practice.

 

Psychosocial Presentation of Autism 

Autism spectrum disorder (ASD) is characterized by many behaviors: Fixation on routines, arranging objects, hand/finger flapping, echolalia, inappropriate use of objects, and movement behaviors. In addition, extreme diets and sensitivity to various stimuli are also characteristic of the disorder. Individuals with ASD may avoid eye contact, show disinterest in others, or express limitations in understanding personal boundaries.

Though behaviors are manifested differently by each person with the disorder, the American Psychiatric Association (2013) agrees that restrictive and repetitive conduct is among the principal diagnostic criteria.

*Click below to learn the early signs of autism in toddlers

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Practitioners and Autism Management

It is important to develop individualized treatment interventions when treating patients with autism spectrum disorder. Thus, patient and caregiver training and education should be given in the appropriate form fitting to the patient’s challenges and strengths.

Early intervention is imperative to improved outcomes in patients with ASD. Examples of early interventions include applied behavior analysis (ABA), speech language therapy, occupational therapy and sensory integration. In addition, cognitive behavioral therapy, and social training are also effective early intervention strategies. 

autism spectrum disorder

Autism Management Continued

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Through early diagnosis and intervention, many patients with ASD learn to function independently. However, for those patients with limited decision-making capacity, the practitioner may collaborate with the patient’s authorized decision maker when creating treatment options.

When dealing with patients with limitation in communication, the practitioner should choose the appropriate language fitting to the patient’s language skill level. Also, effective listening and allowing adequate time for patient response can build patient-health provider rapport and strengthen communication. The use of visual aids can prove effective when communicating with nonverbal patients.

SUBHEADING

 

 

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Blumberg, S. J., Bramlett, M. D., Kogan, M. D., Schieve, L. A., Jones, J. R., & Lu, M. C. (2013). Changes in prevalence of parent-reported autism spectrum disorder in school-aged U.S. children: 2007 to 2011-2012. National Health Statistics Reports, 65, 1- 1.

Center for disease control and prevention (2018). Autism spectrum disorder: Data and statistics. Retreived from: https://www.cdc.gov/ncbddd/autism/data.html

Grynszpan, O., Nadel, J., Martin, J., Simonin, J., Bailleul, P., Wang, Y., & Constant, J. (2012). Self-Monitoring of gaze in high functioning autism. Journal of Autism & Developmental Disorders, 42(8), 1642-1650.

Ozgen, H., Hellemann, G.S., de Jonge, M.V. et al. J Autism Dev Disord (2013). Predictive value of morphological features in patients with autism versus normal controls.  Journal of Autism -and Developmental Disorders. 43(1), 147-155.

Pineda, R., Melchior, K., Oberle, S., Inder, T., & Rogers, C. (2015). Assessment of autism symptoms during the neonatal period: Is there early evidence of autism risk? American Journal of Occupational Therapy, 69(4), 1-11.

Salpekar, J. (2018). Neuropsychiatric effects of epilepsy in developmental disorders. Current Opinion in Psychiatry, 31(2), 109-115.

Thiesen, G., Gribel, B. F., & Freitas, M. P. M. (2015). Facial asymmetry: a current review. Dental Press Journal of Orthodontics, 20(6), 110–125.

Zuckerman, K. E., Lindly, O. J., & Sinche, B. (2016). Parent beliefs about the causes of learning and developmental problems among children with autism spectrum disorder: Results from a national survey. American Journal on Intellectual & Developmental Disabilities, 121(5), 432-447.

 

 

Therapeutic Horseback Riding Treatment for Autism

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1st Experience with Horseback Riding Girl Horseback riding

When my son was 6 months old, I noticed his love for animals. So we joined a baby and me group for a fun event at an animal farm. The farm’s main attraction was pony and horseback riding which my 6-month-old son seemed to really enjoy. Though he was only 6 months old, he had a distinct connection with the ponies that didn’t go unnoticed by the other moms.  Even the farm attendants remarked that he would grow to love and be good at horseback riding. Soon, the day ended and we went on our merry way with no plans to revisit such adventure.

 

 

 

horse therapyFast forward about 6.5 years later. I decided to surprise Liam (my son) on his 7th birthday to an evening of horseback riding. Since he had only been around horses once, an event I was sure he didn’t remember, I carefully approached the situation. Still, I had high hopes that he would enjoy the experience. Even though I hoped for a fun experience , the real reason behind the visit was to broaden his experience of different live animals. You see, he has challenges with receptive and expressive language, so, modeling the word with a clear picture was effective in improving his language skills. This technique we took from extensive Speech therapy . 

 

 

 

Horses for horse therapyOur Horseback Riding Story

We got to the ranch and were greeted by the rancher and 3 horses. There were more than 3 horses on the ranch but those 3 were not barned. Those 3 horses had a special interest in Liam. They insisted on following him regardless of how the rancher shielded him. The rancher called her assistant for backup. I overheard her telling the assistant that the 3 horses insisted on meeting Liam.

What did she mean? I thought. 

“I am sorry for that. Usually these 3 horses show disinterest in our guests which is why we didn’t care to have them out at your arrival. But, for some reason they want to meet your son,”  she said.

I suggested that the horses might have been attracted to Liam because he has autism spectrum disorder (ASD). This I made up to break the ice. That’s when she uncovered that those 3 horses were used in therapeutic horseback riding for children with autism. Since Liam did not demonstrate any ASD stereotypic behaviors at the initial greeting, the thought of the horses being able to identify him as having autism gave me chills. That was also my first time learning about therapeutic horseback riding.

Therapeutic Horseback Riding Treatment for Autism 

Learning to ride horse So what is therapeutic horseback riding and how does it improve autism associated symptoms? Therapeutic horseback riding (TR) or equine assisted therapy is an activity used with individuals with autism and other special needs. It is used for the purpose of improving physical, emotional, intellectual and social wellness. It is also beneficial in improving balance and coordination, fine and gross motor skills (Anderson et al, 2019), as well as providing positive sensory stimulation.

Researchers investigated the effects of therapeutic horseback riding (TR) or equine assisted therapy on social communication and sensory processing skills of children with autism. They found an increased social interaction, improved sensory processing, and decreased severity of symptoms associated with autism spectrum disorders in those that participated in TR (Ward et al, 2013). TR or equine assisted therapy also influences targeted behaviors in children with autism (Holm et al, 2014). Other studies suggest that therapeutic riding also improves irritability in children with autism.

Liam has since been participating in therapeutic horseback riding.  Not only does he love it, but we have seen tremendous improvements in his emotional and social health. 

 

References:

Anderson, S. K., Loy, D. P., Janke, M. C., & Watts, C. E. (2019). The effects of therapeutic horseback riding on balance. Therapeutic Recreation Journal, 53(4), 307–321.

Holm, M., Baird, J., Kim, Y., Rajora, K., D’Silva, D., Podolinsky, L., … Minshew, N. (2014). Therapeutic horseback riding outcomes of parent-identified goals for children with autism spectrum disorder: An ABA′ multiple case design examining dosing and generalization to the home and community. Journal of Autism & Developmental Disorders, 44(4), 937–947.

Ward, S., Whalon, K., Rusnak, K., Wendell, K., & Paschall, N. (2013). The association between therapeutic horseback riding and the social communication and sensory reactions of children with autism. Journal of Autism & Developmental Disorders, 43(9), 2190–2198.

Early Signs of Autism in Toddlers

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toddler with autism

Signs of Autism in Toddlers 

Often, parents and caregivers ignore obvious signs of drawbacks in children. The thought of a child developing differently or even demonstrating traits considered unusual is frightening. Despite fear, it is important to acknowledge early signs of autism in toddlers. Since early identification can lead to better outcomes

The Early Signs 

Four years ago, I was in that same position. My son had normal development until he was three years old, or so I thought. Then I stumbled upon a photo taken a week or so before his second birthday. This seemingly innocent photo compelled me to accept that my son demonstrated signs of autism before I was willing to acknowledge it. In the photo, a close friend of mine three-and-a-half-year old son tried desperately to gain my son’s attention.  At no point did my son acknowledge the other toddler. Instead, he, uninterestedly, gauzed steadily at the floor. Sadly, this was one of many situations where he showed complete disinterest in other children.

In addition to his impaired ability to engage in social relationships with other children, there were other red flags that I ignored. For instance, he played differently with toys. He was obsessed with balls. He could spot a number or letter in any corner of a building. Also, he had strong food preferences and his speech was delayed. Most noticeable, he was a basketball genius. What was most odd though, was that he never crawled. In other words, he skipped crawling and walked at 8 months old. Albeit, he was a toe-walker.

Deciding on Diagnostic Assessment 

Deep down I knew something wasn’t quite right with my son’s development. I shared my concerns with friends and family who reassured me that he was okay and only needed time. Even his pediatrician encouraged me of his normal development.

“Everything seems fine. Boys develop slower than girls. Let’s wait and see,” the pedicatrician said.

Their encouragements did little to alleviate my fears. Then it happened. I received a call from his preschool staff recommending he undergoes screening. Someone else noticed his peculiarity and that was enough to persuade me to take on the difficult challenge of diagnostic assessment. Without doubt, the thought of diagnostic assessment was frightening. I was certainly not ready to confirm what I already knew.

Autism Spectrum Diagnosis 

signs of autism in toddlers My son was screened for autism spectrum disorder by a leading pediatric developmental psychologist in Washington D.C. The session was smooth and informative. I had a clearer understanding of early signs of autism in toddlers. Some early indicators for autism are impaired early language development, impaired social interactions, limited eye contact, unusual response to name and common gestures, etc. (Roberts, 2019).

Facing the truth about my son’s brain function was frightening. Although, not as frightening as not knowing. Evidence suggests that early diagnosis is beneficial, since it promotes early intervention. And early intervention may change the progression of development for children with autism. In other words, children with autism who receive early intervention have better outcomes.

Parents also impact early diagnosis since they are often the first to notice deviation in their children’ growth and development (Warren et a, 2011). Therefore, proper understanding of developmental milestones may be helpful.

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Reference:

Roberts, M. (2019). Seeing ASD signs? Speak up. ASHA Leader, 24(4), 46–55.

Warren, Z., McPheeters, M. L., Sathe, N., Foss-Feig, J. H., Glasser, A., & Veenstra-Vanderweele, J. (2011). A systematic review of early intensive intervention for autism spectrum disorders. Pediatrics, 127, e1303–e1311.

 

Autism Cost

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 Autism Cost in the U.S

After my son was diagnosed with autism spectrum disorder (ASD), I wondered what came next. From my knowledge, he was the only one in the family to have such diagnosis, so I had no clear sense of direction. How did other single parents cope with having a child or children with ASD? How would the diagnosis affect his future? What therapeutic interventions where available? How would we gain access to them? Most importantly, how would I afford such needed therapies on a single household income? I was not prepared, to say the least, for autism cost in the U.S. Despite my worries, I knew I needed a game plan. For my son to function at his best, early intervention was pivotal regardless of its cost.

Available Options 

Certain public schools offer free interventional services to children with autism spectrum disorder (ASD) and other neurodevelopmental conditions. My son received his initial speech and occupational therapies in the public-school setting. He received speech therapy two times weekly and occupational therapy once weekly with each session lasting for 30 minutes. At the time, he was considered nonverbal and since evidence suggests that nonverbal children with ASD achieve better outcomes in language production with intensive speech sessions (Rogers et al, 2006), I knew that an hour of speech therapy weekly would prove insufficient.

Autism cost in the U.S is challenging for parents with children with autism spectrum disorder. Some insurances cover short term ancillary services base on diagnoses. Our insurance covered speech therapy, occupational therapy, and applied behavioral services with our out-of-pocket costs consisting of coinsurance of 20 percent after deductible is met. In addition to speech therapy offered at school, my son received private speech therapy three times weekly for an hour each session; costing $50 per session. That’s $150 weekly for speech therapy alone. Occupational therapy cost mirrored that of speech therapy. Fortunately, we were able to obtain grants that met the remanding balance for applied behavioral services after insurance payment was applied.  This alleviated much of our autism cost. The typical out of pocket cost for speech therapy in the U.S for those not covered by health insurance can range anywhere from $150-$350 for an initial evaluation. Follow-up speech therapy per hour sessions can cost between $100 to $200. These ranges were priced from different therapy centers that did not accept our insurance. After years of speech therapy my son is no longer considered nonverbal; albeit, he still faces minor challenges with receptive and expressive language. We have reduced outpatient speech therapy with more focus on in-home speech and language techniques.

Applied behavioral analysis (ABA) therapy is another intervention of autism. Some studies suggest that behavioral modification programs like ABA therapy is beneficial to language development and impact core deficits of children with autism (Harrington & Allen, 2014). The per child cost of ABA therapy in the U.S is estimated at $45,000 annually. However, not everyone is a proponent of ABA therapy. See ABA Therapy and Autism: Is ABA Abusive to decide if ABA therapy is right for you and your family.

The annual autism cost in the U.S is $137 billion nationally with residual care, loss of productivity, underemployment, and unemployment in adulthood costing $2.3 million (Shiozawa, 2015). Autism cost in the U.S can be quite challenging with the type and duration of needed interventions determining the overall cost. This article focuses on the typical cost for speech therapy and ABA therapy while neglecting autism cost for occupational therapy, special education schooling, and or expenditures on medical and mental health services.

 

 

Reference:

Rogers SJ, Hayden D, Hepburn S, Charlifue-Smith R, Hall T, & Hayes A. (2006). Teaching young nonverbal children with autism useful speech: A pilot study of the Denver Model and PROMPT interventions. Journal of Autism & Developmental Disorders, 36(8), 1007–1024.

Harrington, J. W., & Allen, K. (2014). The clinician’s guide to autism. Pediatrics in Review, 35(2), 62–78.

Shiozawa, B. (2015). It’s About Time for Autism Reform Legislation in Utah. Journal of Autism & Developmental Disorders, 45(5), 1495–1496.

 

 

Omega 3 Fatty Acids and Hyperactivity

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What is Omega 3 Fatty Acids 

omega 3 fatty acids

 

Overtime, fat has been given a bad name. However, not all fats are bad. When it comes to fats with crucial health benefits, omega 3 fatty acids come to mind; especially Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA). EPA and DHA are essential dietary fats found primarily in certain fish. Fetal development, immune function, healthy aging, weight management, and cognitive function are among its many health benefits. 

Omega 3 Fatty Acids and Hyperactivity

Fish oil

The benefits of omega 3 fatty acids are well documented. One such crucial health benefit includes brain health. Omega 3 support brain health through its promotion of proper cell membrane function. DHA, found plentiful in the brain and retina, is essential to cell membrane function. Studies suggest that omega 3 supplementation during pregnancy, especially EPA and DHA, supports proper fetal brain and retina development. Therefore, it is no surprise that DHA and EPA health benefits in neurodevelopmental disorders are being investigated. Studies also suggest that adequate amounts of EPA and DHA levels are important to avoiding or limiting symptoms of neurodevelopmental disorders including autism spectrum disorder.

Sources of Omega-3 Fatty Acids

DHA and EPA Sources 

  • Fatty Fish
  • Krill Oil
  • Fortified Foods
  • Fish Oil Supplements 
  • Algae (DHA)

How Omega-3 Affects Autism Spectrum Disorder

Autism Autism spectrum disorder (ASD) is a developmental disorder with signs and symptoms that usually appear in the first 3 years of life. ASD  affects communication and behavior. Other signs are lacking or inconsistent eye contact, repetitive behaviors, food sensitivity, sensory issues, restricted interests, hyper focus, and hyperactivity. 

While there is no antidote for autism spectrum disorder (ASD), there are interventions that can improve core symptoms of autism including hyperactivity. Studies suggest that children with ASD have lower omega -3 intake when compared to children in the general population (Mazahery et al. 2017). Thus, omega-3 supplementation can have a positive effect on ASD associated hyperactive behaviors when given in adequate amounts. The possibility that mental heath disorders may be linked to abnormalities in fatty acids metabolism have sparked further interests in the link between omega-3 fatty acids and autism spectrum disorder. 

Dosage Use In Autism 

In a study, 500 mg capsules omega-3 fatty acids were given to participants twice daily. With each 500mg capsule containing 190 mg of eicosapentanoic acid and 90 mg of docosahexaenoic acid. Finding suggested that improvement from baseline to 12 weeks averaged 33% with most improvement experienced during the first 6 weeks (Meiri, Bichovsky, & Belmaker, 2009).

Home Trial

My experience with omega-3 fatty acid and hyperactivity was positive. Since, omega- 3 fatty acids have been proven to support long term concentration in adults; it was an easy decision for me to supplement my adorable, yet overly active 6-year-old son’s diet with omega-3. After consistent use, I noticed a change in his behavior and speech. His hyperactivity is reduced. He now sits during home lessons; albeit, we take small breaks. He also will enjoy up to 15 minutes of quiet time watching a movie; tasks that were nearly impossible for him to achieve prior to omega-3 supplementation. While I do not consider omega 3 supplementation a fix-it-all solution for autism associated hyperactivity, when used with other interventions and dietary adjustments it can facilitate positive outcomes in children with ASD. My son is proof of the effects of omega 3 fatty acids and hyperactivity! 

Reference:

 

Gal Meiri, Yoav Bichovsky, & R.H. Belmaker. (2009). Omega 3 fatty acid treatment in autism. Journal of Child & Adolescent Psychopharmacology, 19(4), 449–451.

Mazahery, H., Stonehouse, W., Delshad, M., Kruger, M. C., Conlon, C. A., Beck, K. L., & von Hurst, P. R. (2017). Relationship between long chain n–3 polyunsaturated fatty acids and autism spectrum disorder: Systematic review and meta-analysis of case–control and randomized controlled trials. Nutrients, 9(2), 28.