Autism Therapy: developmental pediatrician

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A study from The Children’s Hospital of Philadelphia (CHOP) found that two-thirds of teens with high-functioning autism disorder (HFASD) in PA are driving or are planning to drive. Dr. Patty Huang, a developmental pediatrician, explained that there is not a lot of research explaining how a teen with HFASD might perform as a driver. Because car wrecks are the leading cause of teen deaths, the research hopes to suggest evaluation and appropriate driver training. The researchers surveyed 300 parents of teens and developed a list of characteristics that seemed predictive of teens with HFASD who will drive. CHOP has created a site, teendriversource, for parents and educators.

Read original article: What to Consider When Teen with Autism Want to Drive



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Travelling with Special Needs Children

Dec 10, 2008 by Anonymous

TEN TIPS TO EASE HOLIDAY TRAVELS WITH SPECIAL NEEDS CHILDREN:

Pediatric Therapist Aviva Weiss Tells How to Prepare for Good Times Together

Philadelphia, PA, December 8, 2008 - The chaos of packing, airport crowds and security, lengthy car rides and yes, even overexposure to family and friends is enough to erode any holiday traveler's festive spirit. Add traveling with children into the equation, especially when special needs are involved, and some parents might wish they could just stay home. But a few preparations, says Fun and Function LLC founder Aviva Weiss, can go a long way toward ensuring a good time for everyone.

Traveling disrupts routines and familiarity with the surrounding environment and can be difficult for children with special needs notes Weiss, a certified pediatric occupational therapist. A mother of four, including a daughter with sensory processing disorder, she says parents of special needs children can pave the way toward less stressful trips by observing these ten guidelines:

1. Prepare the child in advance as much as possible. Practice for the trip for a period leading up to the actual travels. Talk about the upcoming experience to help your child overcome anxiety. Act out or role play anticipated events in advance, from taking off shoes for airport security to applauding after a toast.

2. Redirect anxious energy into constructive activity. To take the edge off the potential anxiety of seeing many less familiar faces all at once, make the event a fun and educational by creating a special activity. Create a small photo album featuring people who will be at the event, and help your child play "Family Bingo," checking off each person he or she greets or sees across the room. Or, create a pictogram of your itinerary or agenda and help your child follow along.

3. Encourage creative expression. For those able to write or draw, a pocket journal or sketchbook for illustrating what they're experiencing can provide another useful outlet. Children who are more observers than participants may appreciate assignments such as taking pictures with a digital camera.

4. Don't expect perfection. Whenever you travel with children, it's best to "expect the unexpected," or at least leave room for something to pop up to divert you from your agenda.

5. Secure an extra set of hands. Try traveling with a friend, family member or caregiver to help keep things in order when you're on the move, provide manpower for carrying belongings and an extra set of eyes, and even make bathroom breaks with multiple children an easier task.

6. Manage expectations for you and your hosts. A pending visit from a special needs child may produce stress for the host as well as the child and the parent. Prepare everyone by communicating your child's needs in advance and asking for some general ground rules for inside the home, as a gesture toward making the visit as pleasant and peaceful as possible.

7. Bring along some "friends." Pack a bag of objects that are fun and familiar. Sensory gadgets/fidgets, noise reduction headphones, weighted vests, or favorite belongings from home will help filter out outside stimuli and provide a comforting connection to "home."

8. Minimize changes to eating habits. Try to keep your child's diet consistent to prevent constipation, indigestion, allergic reactions or other adverse developments. Feed your child something satisfying to comfort them before a long trip, and take along favorite utensils as a connection to more familiar situations. Don't expect your child to sit for an entire meal. Rather, prepare a spot where he or she can rest, play or calm down while the meal continues.

9. RX for safer travels. Ready a medicine kit with prescriptions, medical information and OTC products to confront fevers, allergies, cuts and other issues that may surface when you travel out of your home.

10. Preserve the moment but reserve time for breaks. The ingredients of posing for pictures - people huddled close together, bright flashes, noise and the need to stay still - can lead to overstimulation. Don't oblige your child to participate in all the photos, and be sure to take breaks in between.

"Traveling with a special needs child - or any child, for that matter - needn't be a stressful event," Weiss says. "In fact, it can be a great experience, offering lessons and fond memories for all. The keys are to prepare everyone in advance, include a few fun and familiar items and activities, and above all remember that it takes time and patience to learn how to manage change."

About Aviva Weiss and Fun and Function LLC

Aviva Weiss is founder of Fun and Function LLC, a Merion Station, Pa.-based provider of engaging, durable and functional play and therapy products at affordable prices, including an exclusive line of scooters and portable writing kits. A mother of a child with sensory processing disorder, she is also a certified pediatric occupational therapist with expertise in creating inclusive environments where all children can thrive together, and is currently working with developmental pediatrician Dr. Wendy Ross to guide children's museums toward improving experiences for children with special needs and their families. She previously worked at Children's Hospital of Philadelphia and St. Christopher's Hospital, and earned her B.S. in Psychology from Touro College and her Masters in Occupational Therapy from The Richard Stockton College, graduating summa cum laude from both programs.

Weiss launched Fun and Function in 2005 when she first identified her daughter's challenges and was frustrated by the lack of kid-friendly styling and high prices of existing special-needs products. She began designing products that elicit the potential of all children, help them feel good and achieve their best. Today, the company offers hundreds of innovative products marked by affordability and durability, scoring points with parents, pediatric therapists and educators. For more information or a free catalog, visit www.funandfunction.com or call 1-800-231-6329.

 


Yummy Food or Yucky Food

Sep 11, 2008 by Anonymous

One Person's Yummy Food Is Another Person's Yucky Food

Vegetables and protein (fish, poultry, meats, and beans) are the most common food aversions. Some children even reject fruits. The diet becomes extremely restricted to bland, white foods, including sweets, breads, pasta, crackers, pretzels, chips, and macaroni and cheese. These foods are glycemic and raise blood glucose, quickly increasing the demand for insulin production. Zinc is part of the insulin molecule and is depleted, resulting in abnormal taste and taste perception. What develops is an aversion to the flavors in natural foods and increased cravings for highly sweetened foods and those foods containing MSG. (MSG affects the brain's perception of flavor.) The diet becomes more narrow, and nutritional status declines, resulting in more limited food choices. The white diet and vegetable aversion is common among children in Western cultures due to the high exposure to processed and sweet foods. For children with sensory and developmental issues, the aversions are much more pervasive and serious.

There are three potential contributors that lead to the limited appetite, cravings, and food aversions:

  1. The formation of opiate-like peptides from gluten and milk products, resulting in cravings for the foods that are the sources.
  2. Zinc deficiency or deficiencies in zinc metabolism and function. Zinc is responsible for sensory development and function, including taste and taste perception.
  3. The presence of toxic metals that can interfere with sensory development and function.

The negative effect of this combination can result in faulty messages from the sensory receptors to the brain and dysfunctional interpretation of those messages by the brain. Perception is the "truth" for that person. This is why begging, bribing, and punishing do not and will not work.

The solution is multifaceted. Correction of nutritional deficiencies and elimination of toxic metals are mandatory and involve appropriate therapeutic supplementation based on findings. Foods that cause reactions and/or opiate-like peptides need to be eliminated as healthy, safe foods are introduced and accepted.

How to Go from Yucky to Yummy-The Trojan Horse Technique

For those with texture issues, it is important to adapt the diet to the child's oral and food developmental stage. If textures are a sensory issue, no matter how tasty the food, it will not be consumed. By providing the food in a sensory-pleasing form, the child benefits nutritionally and begins to find mealtime more pleasant and rewarding. Purees are generally helpful. They are better tolerated and can open the door for getting more types of foods into the diet. Many family dishes, including soups, casseroles, or the meat and vegetable main dish, can also be served pureed for the child who has sensory texture issues. In this way, the whole family is enjoying the same meal.

Many of the recipes in this book have been selected to expand nutritional intake, especially using the Trojan Horse Technique-hiding a small amount of the new food (especially vegetables and proteins) within a very well tolerated and acceptable food. Each child differs and, therefore, it is important to identify what foods will work as "carriers" to get the new foods in.

Purees can be made from cooked fresh or frozen vegetables and/or purchased baby foods. If your child is offended by being served baby food, simply keep it well hidden. Create interesting new names for the foods and see that others in the family join in consuming them. The secret to success in introducing these new foods is to combine a small amount with the food the child already likes. For many children, this is the only way new foods can be introduced.

Start with 1 tablespoon (15 g) or less-and then increase when tolerated. Hide the cooked vegetable purees anywhere you can, selecting colors that are not obvious when added to the carrier food. The carrier food needs to be one that the child enjoys. It may even be a food that is being slowly eliminated. Include pureed fruits to improve the taste. Here are some examples of places to hide foods (and even supplements):

  • Spaghetti Sauce. Blend the pureed vegetables thoroughly with at least three times as much spaghetti sauce; then hand-mix the new blend in with the rest of the sauce. Carrots, beets, sweet potatoes, turnips, squash, green beans, and peas are easy to hide in spaghetti sauce. Watch the amount of green if it is a food color that your child rejects.
  • Muffins, Cakes, and Brownies. Well·pureed foods are easy to hide in these batters, including pureed chicken and turkey. A chicken/vegetable/fruit muffin becomes a healthy meal!
  • Pancakes. Not only can pureed vegetables and fruits hide well in the batter, but they are also a good hiding place for supplements such as protein powders, calcium, magnesium, and zinc.
  • Peanut Butter. If a child likes peanut butter, it is an excellent medium for adding small amounts of protein and nutritional supplements.
  • Meatballs. If these are well liked, especially with spaghetti sauce, the job becomes a whole lot easier. Well-pureed vegetables and fruits are an excellent thickener/filler for meatballs. Make many and freeze them, and then bring them out for snacks.
  • Juices, especially those with a strong flavor, such as pineapple juice, grape juice, nectars, apple cider, and orange juice.
  • Smoothies, Fruit Purées, and Applesauce. These offer an unlimited opportunity for expanding nutrition and an excellent way to hide supplements. Protein powders can be included to expand protein intake, especially for those with texture issues who avoid meat, beans, and other sources of protein. Always start with the fruit your child favors and then expand.
  • Let chocolate be your friend. There are sources of GFCF chocolate chips, sauces, powders, and so forth. Check the product search section of the GFCF Diet site (www.gfcfdiet.com/directory.htm).
  • Add unflavored gelatin to cooked purees to lend more substance and improve digestion.

The above is an excerpt from the book The Kid-Friendly ADHD & Autism Cookbook: The Ultimate Guide to the Gluten-Free, Casein-Free Diet
by Pamela J. Compart, M.D. and Dana Laake, R.D.H., M.S., L.D.N.
Published by Fair Winds Press; November 2006;$24.95US/$32.50CAN; 978-1-59233-223-6
Copyright © 2008 Pamela J. Compart, M.D. and Dana Laake, R.D.H., M.S., L.D.N

Author Bio
Pamela J. Compart, M.D., is a developmental pediatrician in Columbia, Maryland. She combines traditional and complementary medicine approaches to the treatment of ADHD, autism, and other behavioral and developmental disorders. She is also the director of HeartLight Healing Arts, a multidisciplinary integrated holistic health care practice, providing services for children, adults, and families.

Dana Godbout Laake, R.D.H., M.S., L.D.N., is a licensed nutritionist in Kensington, Maryland. Within her practice, Dana Laake Nutrition, she provides preventive and therapeutic medical nutrition services. Her practice includes nutritional evaluation and treatment of the full spectrum of health issues affecting adults and children with special needs.


School Lunches for Kids with ASD

Sep 11, 2008 by Anonymous

SCHOOL LUNCHES FOR KIDS WITH ASD: DELICIOUS, HEALTHY & POSSIBLE.

THE CHALLENGE:

With only twenty minutes to eat, kids with autism spectrum disorder (ASD) should have "fast" foods that are healthy, tasty, loaded with nutrients and free of the culprits that are common problems: gluten, milk products, soy, and artificial additives and coloring. Add to the list sensory issues involving food texture, color and taste along with unusually picky appetites so common in ASD - and the task seems insurmountable. Beyond the challenges with foods are the safety issues of the food containers themselves, especially plastics containing phthalates and bisphenyl A (BPA). And of course there is the "cool" factor which affects pre-school through high school. Food that is different is totally uncool for kids who already face so many social and learning stigmas.

Knowing the challenges, we can now focus on the solutions.

THE SOLUTIONS:

Basics

As is the case with any meal, there are some basics to follow. Blood sugar control is critical. All people are affected by rapidly rising blood sugar which then cascades down too quickly and too low. The most noticeable effects are on brain function especially mood and attention. As the blood sugar drops too quickly, there can be irritability, hunger headaches, lack of focus, behavior problems, and cravings for a "quick sugar fix" which keeps the cycle going. This interferes with learning and can be disruptive to the class. Protein and fiber stabilize blood sugars. Below is a summary of the basic rules for any meal including school lunch.

Assumptions

All food suggestions are GFCF (gluten-free, casein-free). Glutens include wheat, oat, barley, rye, spelt and kamut. Milk products and milk casein include milk, yogurt, cheese, creams, ice cream, cream sauces, and butter.

Avoids

Glycemic foods which raise blood sugar (glucose) quickly include: sugars, sodas of any kind, candy, sweets, juices, and any refined grains (pretzels, bread, crackers, bagels, chips) on an empty stomach. Limit the sugars and keep the refined carbohydrates limited. If small amounts are consumed at the end of the meal, the negative effect is less.

A word on sodas - both regular and diet. They have no place in a healthy diet. They are high in phosphorus which depletes healthy nutrients. Consider them removers of electrolytes, not drink options. Water is best, but other good choices include: dilute juices, seltzer water with juice to flavor, vegetable juices (V8)

Promote Protein at every meal or snack

Choices include fish, poultry, meat, eggs, beans, nuts and seeds.

Avoids: milk products

The serving size for protein for each person is the size of the palm. A child's may be 1 to 2 ounces of meat/chicken/fish and a teen and adult may be 3 to 5 ounces. See the chart for guidelines

For beans, the serving size is two cupped palms full. See the chart for guidelines.

Fabulous Fiber at every meal

Choices include fruits, beans, nuts, seeds and grains.

Avoid: glutens

If your child eats very few vegetables, fruits, grains, nuts, seeds and beans, added fiber is important. Fiber as pure guar gum is easy to add to any recipe and also to drinks. It is GFCF and more fine than sugar, mixing completely in water or juice. See the table for fiber intake suggestions.

Favorite Foods at every meal or snack

Include at least one food that is a favorite in order to promote more interest in the meal.

Fun Meals - Part of the Cool Factor

Take a tip from the fast food marketers and include a surprise gift in the lunch. It might be a small collectible such as cars, baseball cards, characters, hair clips, stickers, or child's ring or bracelet. Home made "giftlets" (tiny gifts) are perfect.

Guidelines and Ideas

Go organic as much as possible. "USDA Organic" means the food is produced without the use of harmful pesticides, artificial fertilizers, antibiotics, growth hormones human waste, or sewage sludge, and that they were processed without ionizing radiation or food additives. Children with ASD are already coping with their own excess metabolites and really can not handle the burden of harmful chemicals in the environment and foods. The less the exposure the better. Anything you can do for your child is a benefit.

There are numerous resources for GFCF foods and recipes online and in many books. Utilize all of these to find the commercially available foods your child will eat as well as recipes that are not just GFCF, they are nutritious and delicious. Test them at home - not in the school lunch. There are GFCF juice boxes, pretzels, breads, wraps and snacks.

Establish three to five basic lunches that work. If your child is willing and interested, engage him or her in the process. Test new foods out at home until you have the food right and the combination of foods right.

Use freezer packs for keeping foods cold and thermos for hot foods. Include non-toxic hand sanitizers which are commercially available (avoid the commercial sanitizers). You can also send two paper towel pieces - one moistened with soap and one moistened with water..

Packaging - a good opportunity to Go Green!

Again - go with the marketers - jazz it up! Select a lunch container your child loves. Young children love to decorate a lunch box with stickers and paints. Make the lunch box the child's own work of art personalized with a name. Reusable containers and boxes are the green way to go. Older children will definitely want to select whatever is considered cool. The most cool may be a paper bag or small recycled bag carried in a back pack. Go with the trend and your child's own choice. There are companies who make safe, BPA-Free, safe lunch box sets with inserts for the different foods.

To avoid plastic wraps for sandwiches, use wax paper or parchment paper. Avoid containers with BPA by avoiding items with the recycle number 7. There are many BPA -Free containers which can be washed and reused. Your child will need to know to bring these back home rather than throw them away.

For napkins, use washable cloth napkins or dishcloths, or choose processed chlorine-free (PCF), post-consumer-waste (PCW) paper napkins available in stores and on line. If utensils are needed, use stainless steel appropriate to the child's skill level and age.

Nutritious Can Be Delicious - Even for the Picky Eater - The Trojan Horse Technique

Remember Odysseus from seventh grade mythology? Seeking to gain entrance into Troy, he cleverly ordered a hollow wooden horse so large that the Greek army could hide inside. What looked like a huge horse was really a disguise to conquer the city. We have used this concept for decades to hide nutritious food to nourish picky eaters.

Rather than introduce a new food in its natural form, begin by hiding a very small amount (about a tablespoon) of it as puree mixed or blended into a well-liked and well-tolerated food. This approach allows the body to accept the new food. As the child accepts the taste, include more. Children who have food texture issues are especially good candidates for blended foods because their sensory development may be younger than their chronological age. Adapt to the sensory level and return to purees until sensory issues improve. Rather than focusing on getting a child to tolerate foods that he perceives as "lumpy" or unpleasant to chew, the goal is getting a child to eat nutritious food, however you can.

Match the Color and Texture

Assume the new food is a vegetable, use organic baby food purees or make your own. Puree the new food into an established food that does not change the overall color, texture, smell, or taste. If a child eats nothing but white food, start with very light-colored vegetables including squash, cauliflower and corn. If the child likes ketchup or tomato sauce, then introduce deeper-colored vegetables such as beets, greens, peas and beans. Pureed vegetables can be beaten into batter for pancakes, muffins, brownies, and cookies or into tomato and other pasta and pizza sauces, and even into ketchup.

Mix Fruits and Vegetables

Vegetable juice makes a healthy addition to fruit juice. Try mixing carrot juice with orange juice, and then adding a teaspoon or so of another vegetable juice. Serve in a brightly colored sippy cup to camouflage any color changes. Blend pureed vegetables into cooked fruits such as applesauce or pearsauce, into meatballs, and even into nut butters. Expand ideas as tolerance improves. Be sure to carry out the Trojan Horse technique out of the sight of your child!

Muffin Casseroles

Many families have developed what we call muffin casseroles. One resourceful mother developed a GF/CF muffin for her child who ate only breads and muffins, and then gradually added fruit puree to the batter. As he tolerated fruits, she moved to vegetable purees, and finally added pureed meat. Until he was able to transition to eating foods in a traditional manner, he ate his muffin casseroles at every meal and snack-and loved them!

Increase Protein

The Trojan Horse technique is especially useful for kids who need more protein in their diets. Add eggs, especially the high-protein whites, and rice-protein powders to batters, breads, smoothies, meat sauces and meatballs. Do not add raw eggs to smoothies.

Gradually Move On

AS your child expands to eating vegetables, try vegetables dipped in honey or mayo/ketchup mix or hommus. It is a start . As a child accepts an increasing number of foods presented in a sneaky manner, eventually, he/she will accept the food alone - we promise! All it takes is patience, and a lesson from Greek mythology!

Choose one from each section. This list is GFCF. Also avoid any foods which provoke reactions or those forbidden at school (nuts for examples) or foods The "Other" section is optional.

Some Protein Choices: chicken strips, GFCF chicken nuggets w/ketchup to dip, meat slices rolled up, shrimp (send frozen, will thaw by lunch) w/seafood sauce to dip, organic "deli" chicken slices, hommus plain, on bread or crackers or as dip for veggies, muffin "pot pies", soy yogurt, egg salad, hard boiled eggs or deviled eggs, peanut butter on crackers or apples, nuts - all varieties - almonds, cashews, pecans, pistachios, hazelnuts. Hot food for thermos: chili or soups, turkey hot dogs cut up, GFCF pizza.

Some Vegetables & Fruit Choices: These can be eaten plain or dipped in GFCF sauces, ketchup or honey. Foods include: cup of vegetables, baby carrots or carrot strips, broccoli "trees", apples, bananas, berries, oranges, peaches, grapes, pineapple, melon, natural fruit cocktail in natural juice, raisins, apricots,  applesauce in cups, any blended fruit sauce.

Drink Choices: water, fruit juice, V8, V8+fruit, seltzer w/juice, fruit smoothie, other milk (soy, rice, coconut, almond), and keep drinks partially frozen so they will remain cold. 
Other: GFCF pretzels, rice crackers, baked tortilla chips, GFCF dry cereal, GFCF vegetable gummies, small GFCF cookie.

The above is an excerpt from the book The Kid-Friendly ADHD & Autism Cookbook: The Ultimate Guide to the Gluten-Free, Casein-Free Diet
by Pamela J. Compart, M.D. and Dana Laake, R.D.H., M.S., L.D.N.
Published by Fair Winds Press; November 2006;$24.95US/$32.50CAN; 978-1-59233-223-6
Copyright © 2008 Pamela J. Compart, M.D. and Dana Laake, R.D.H., M.S., L.D.N

Author Bio
Pamela J. Compart, M.D., is a developmental pediatrician in Columbia, Maryland. She combines traditional and complementary medicine approaches to the treatment of ADHD, autism, and other behavioral and developmental disorders. She is also the director of HeartLight Healing Arts, a multidisciplinary integrated holistic health care practice, providing services for children, adults, and families.

Dana Godbout Laake, R.D.H., M.S., L.D.N., is a licensed nutritionist in Kensington, Maryland. Within her practice, Dana Laake Nutrition, she provides preventive and therapeutic medical nutrition services. Her practice includes nutritional evaluation and treatment of the full spectrum of health issues affecting adults and children with special needs.


hello

Mar 18, 2008 by Anonymous

hello my name is sara and i have a son who is 2 years and 9 months old. we are currently going through all the evaluations and therapies and still do not have a deffinet diagnosis. The developmental pediatrician says he is too young to diagnosis as of now but we should continue to treat him as thoe he is autistic. Has any one else been told this before? 



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