Autism Therapy: eating

definition of eating: not yet defined.

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Journal of Child Neurology, by Kossoff, EH, Zupec-Kania BA, and Rho JM, published in 2009, summarized Jan 1, 2010

A ketogenic diet that cuts down on carbohydrates may be helpful for children with autism and may help reduce seizures.

With a ketogenic diet, most of the daily nutrition comes from eating fat and protein. The Atkins diet is a type of ketogenic diet. Ketogenic diets have been reported to be helpful for children with epilepsy. While on the diet, some children have fewer seizures. Some children with autism also have seizures, so the diet may be helpful for children with autism as well. Neurologists are exploring whether a ketogenic diet may also be helpful for other autism symptoms. However, there were no published studies reported in the article about this diet and autism. There have been side-effects reported, and some can be long-lasting. Side effects include slower growth, digestive system problems, kidney stones, bone fractures, and other problems.


Behavioral Interventions, by Sharp, WG, and Jaquess DL, published in 2009, summarized Nov 26, 2009

Children with autism who are very picky eaters may also have poor eating motor skills like chewing and swallowing.

Some children with autism may not have enough calories and vitamins and minerals if they are very picky about what they eat. Behavioral therapy, based on ABA therapy, may help children eat a broader range of foods. This case study described a 3 year-old boy who was eating only liquid food (PediaSure) given by a bulb syringe. He was not eating enough calories every day to grow. He would get upset when more food or other foods were given to him. He would not swallow food and sometimes gagged. The behavioral therapy plan involved slowly giving him new foods in this order: 1) less than a teaspoon per bite of 16 pureed foods; 2) slowly making the bite size larger; and 3) slowly increasing texture. The authors said that each child may have different problems, and the therapist may help figure out which part of eating the child may need help with.


Current Neurology and Neuroscience Reports, by Zecavati, N., and Spence SJ, published in 2009, summarized Apr 6, 2009

Future research may show that metabolic supplements such as carnitine, coenzyme Q, and/or vitamin B12 can help some children with autism.

This review article describes the role of energy use (metabolism) in autism. The authors describe how some metabolic disorders can give the symptoms of autism. There are no good studies that show how many children with autism have metabolic problems. The authors suggest that doctors look at each patient and decide whether or not to order metabolic tests. Some metabolic problems have simple treatments such as eating more cholesterol or taking biotin supplements.


Journal of Positive Behavior Intervention, by Binnendyk, L., and Lucyshyn JM, published in 2009, summarized Mar 18, 2009

Applied behavior analysis (ABA) therapy may be a useful feeding intervention for children with autism.

This case study was designed to see if a type of ABA therapy (positive behavior support) could help a child with autism learn to accept food. This type of family-centered therapy seemed to result in lasting changes in the child's eating behavior. The therapy also involved a larger support process that improved family life. The six-year-old boy began to accept food (scrambled eggs, hot dogs, etc.) that he had stopped eating before the study started. The authors suggest that studies be done with children of different ages and different types of families.


A mom believes that her son with autism and aggression has improved behavior since beginning medical marijuana therapy. She tried traditional drug therapy with him, including risperdal, but that seemed to make him heavy, stronger, and still aggressive. The family contacted a medical cannabis doctor who agreed that a "speck" of marijuana given in a piece of fruit might help. His parents report, "It was an amazing experience, I'll never forget it, as we watched what happened, it was like 'He's back!' It was like all this anguish, pent-up rage and aggressiveness went away - it just calmed him down." Another mother with an autistic child who also had eating disorders gives her child a small bit of marijuana-infused oil in tea and cookies. She reported, "For the past year, he'd consistently had 30 to 50 aggressions in a school day, with a one-time high of 300. The charts for June through July, by contrast, showed he was actually having days-sometimes one after another-with zero aggressions." Doctors caution that more research needs to be done on marijuana as treatment for autism and many see drug therapy as a last resort.

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Carol Stephens, an occupational therapist in North Carolina understands the need for an OT clinic; she has a special needs child herself. In Davidson County where she lives, there were no freestanding occupational therapy clinics, so she built one. OT 4 Kids is a large space filled with bikes, gym equipment, slides, and even a rock wall. She is also able to teach living skills, such as feeding and eating. Stephens explains that "OTs look at the whole person and their functioning skills." Occupational therapy focuses on the upper body motor skills, oral motor skills, and sensory processing issues.

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The Kindle Center is a new resource in Massachusetts where children with autism can receive social skills training, eating assistance, speech therapy, and dance therapy. In addition, their parents can receive training in order to help their children at home. The Kindle Center motto is “Independence, Progress, Friendship, Learning, Success”, skills they would like all their students to achieve. Applied behavior analysis (ABA) is the basis upon which the center is focused. Arianne Kindle says, “ABA has been proven time and time again to be an effective way to teach children new skills and to teach appropriate, alternative behaviors to stigmatizing or maladaptive behaviors.”

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Springfield School District Youth Transitions Program in Oregon sponsors a greenhouse tended by children with autism and other special needs. The new gardeners are supplying the Springfield Farmers Market with fresh vegetables they've grown themselves. Kevin Hillman, a transition specialist says, "I think there's therapy in gardening, I think there's therapy in planting." Along with gardening skills, students learn life skills that will help them transition to community and retail jobs. They are also learning about the local economy and how supporting local businesses and eating locally grown foods are beneficial.

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Living Gluten Free – Right to Heal

Feb 22, 2010 by karmic health

By Sandi Star, CCN


After struggling for over 40 years with chronic migraines, IBS, Muscle and joint pain, fatigue, brain fog, asthma and a slew of other ailments and frustrations I decided to take a closer look at the cause rather than obsessing on the symptoms. I was tired of relying on doctors to give me answers and tired of the medications that only gave me side affects and little relief.


I had been committed to health and fitness for over 20 years, losing close to 50 pounds and 5 dress sizes, however I still had all the chronic conditions that played havoc in my life. I realized there was a key element missing and soon found out it was my reaction to gluten and dairy. I didn't know enough about food intolerance or allergies or at least put the two together. I never believed food could have such a serious impact on overall health let alone be the direct cause of my diseases. With what I know today I’m surprised my doctor didn’t put the connection together when he diagnosed me with Sjögren’s Syndrome (autoimmune disease). Sjögren’s is one of the symptoms of Celiac along with a long list as you will see below and nutrition plays a critical role in the healing process. By making the appropriate diet changes – (gluten and dairy free), I’ve managed to eliminate my migraines, IBS………etc., etc., and have the Sjögren’s Syndrome under control. Even better, I have eliminated all medications and use food and natural remedies for nutrition and overall health. Now that you know why I became a clinical nutritionist and why I started Karmic Health lets get into the details of why it’s so important to understand gluten and its relation to diseases.


Why the problem with gluten now? A lot has changed in the way we harvest food compared to 50 years ago. Some of the seed companies began engineering wheat kernels that could be more easily ground and produce fluffier flour to make the soft, delicious white bread for example had to have greater yields; it made more money for the farmer and increased sales.


Gluten is a composite of the proteins gliadin and glutenin. These exist, conjoined with starch, in the endosperms of some grass-related grains, notably wheat, rye, and barley.


Understanding what happens in the body and some of the symptoms will help millions of people who go undiagnosed. Celiac is the most common genetic disease of mankind (yet for every person diagnosed, 140 will go undiagnosed).


A wheat allergy is the body’s abnormal autoimmune response to a certain protein component of wheat; it’s exhibited by a severe sudden onset allergic reaction. Usual symptoms are immediate coughing, asthma, breathing difficulties, and/or projectile vomiting. It can cause life-threatening responses in allergic people. A true Wheat allergy affects less than 1/2 % of population. 


Intolerance's are much more common than true food allergies but are harder to diagnose. Food intolerance is an adverse reaction to food that does not involve the body's immune system. Generally food intolerance is an inability to properly digest certain foods. In some cases food passes right through the body before digestion is complete.


Leaky Gut is an increase in permeability of the intestinal mucosa to luminal macromolecules, antigens, and toxins associated with inflammatory degenerative and/ or atrophic mucosa or lining. Put more simply, large spaces develop between the cells of the gut wall allowing bacteria, toxins and food to leak into the bloodstream. Leaky Gut Syndrome has also been linked with many conditions, such as: Celiac Disease, Multiple Sclerosis, Fibromyalgia, Autism, Chronic Fatigue Syndrome, Irritable Bowel Syndrome, Eczema, Dermatitis, and Ulcerative Colitis. 


Celiac disease is an autoimmune disease caused by an inappropriate immune response to dietary proteins found in wheat, rye, and barley (gluten and


gliadin). This response leads to inflammation of the small intestine and to damage and destruction of the villi that line the intestinal wall. These villi are projections (small folds) that increase the surface area of the intestine and allow nutrients, vitamins, minerals, fluids, and electrolytes to be absorbed into the body. When the villi are destroyed, the body is much less capable of absorbing food and begins to develop symptoms associated with malnutrition and malabsorption. When the body is exposed to the gluten and gliadin proteins, it forms antibodies that recognize and act against not only the grain proteins, but also against constituents of the intestinal villi. As long as the patient continues to be exposed to the proteins, he will continue to produce these autoantibodies. Celiac disease is found throughout the world but is most prevalent in those of European descent. It can affect anyone at any age and is more common in women. It is thought to be an inherited tendency that is triggered by an environmental, emotional, or physical event – although the exact mechanism is not fully understood.


According to the National Digestive Diseases Information Clearinghouse, about 5 to 15% of close family members of a celiac disease patient will also have the condition.


Symptoms


There are literally dozens, if not hundreds, of symptoms of gluten intolerance. It all comes down to inflammation in the body! Many people believe the most common symptoms are gastrointestinal in nature - yet the majority of people with gluten intolerance (and celiac disease) have extraintestinal symptoms. 


The most common symptoms of celiac disease include:


Fatigue


• Addison’s disease (hormonal disorder)


Gastrointestinal distress (gas, bloating, diarrhea, constipation, vomiting, reflux)


• Headaches (including migraines)


• Infertility


• Mouth sores


• Weight loss/gain


• Inability to concentrate


• Moodiness/depression


• Amenorrhea/delayed menarche (menstrual cycles)


• Bone/joint/muscle pain


Dental enamel hypoplasia (dental enamel defect)


• Short stature


Seizures


• Tingling numbness in the legs 


The “cure” is a life long gluten free diet.


Making the Transition


1. Have a reality check. Remember this is a choice! If you want to feel lousy for the rest of your life and get worse as time goes on then continue eating gluten. If you want to start on a journey to heal; go gluten free


2. Give it time. It takes time to heal. Take the 45 day challenge.


Within this time frame you will notice the brain fog is gone. Your body will start adjusting to a healthy weight. Yes, you will lose the bloating and weight around the middle. Don’t be discouraged if it takes a little longer to feel 100%. 


3. Look at your current diet and go through your pantry and refrigerator to find the foods and meals you already eat that are gluten-free. You may need to keep a food journal if you haven't already.


Be sure to list condiments, ice creams, produce, snacks, and other foods.


This list will be helpful as you create menus around your new foods and give you encouragement that you're already on the right track!


4. Give yourself permission to eat things that you may have restricted from your diet before your diagnosis. Potato chips or GF cookies may not be appropriate for other people, but they are a treat in a GF diet in small doses of course. You will need to find treats for yourself initially as you adjust to this diet. Count calories after you are comfortable with your new way of eating, manage your portions instead.


Once you are comfortable with the switch start cutting back on refined grains, crackers, breads, etc., to help the gut heal quicker. In all honesty, bread will not be that important. It's all about taking baby steps! 


5. Look at your current menus and meals and find ways to eliminate gluten from your diet. Replace bread in sandwiches with GF bread or green leaf lettuce and add your favorite fixings and condiments. Have breakfast burritos with rice tortillas instead of toast and eggs. Look for GF hot and cold cereals (must not have barley malt) and have those handy for a snack or meal. Replace bread and crackers with tortilla or corn chips, brown rice cakes or popcorn. For example, chicken or tuna salad on rice cakes or scooped onto corn chips is delicious. Popcorn is a filling side dish with soup. Be on the lookout for meals on your current menus or the menus of friends and family that are naturally gluten-free (roasted chicken, baked sweet potatoes and steamed veggies, for example) and make them a staple on your new menus. Surf the internet, watch cooking shows and browse magazines for ideas and adapt them as you see fit.


6. Clear out any and all foods that have gluten, wheat, wheat flour, oats, oat flour, rye, semolina, or modified food starch from your pantry. This will allow you to see how close you are to living gluten-free already. If you have family members living with you who are not gluten free, you might consider giving the "offending edibles" to them to be put in another part of the house while you learn to live and think gluten-free. As time goes on you can cook for the entire family without gluten.


7. Plan and prepare your meals ahead of time. Being caught hungry without a plan is not a good idea! Keep a few GF soups on hand in case of extreme hunger. Keep a small cooler in your car with snacks such as nuts, dried fruit and water. It helps to outline and pack any meals you're eating at home and away from home, including snacks. An example could be -


o Breakfast: scrambled eggs and mixed vegetables rolled in a rice tortilla, sliced apples, and coffee.


o Lunch: Lettuce with turkey, avocado slices, tomato, and mustard, 1 oz. chips, and 2 organic dark chocolate pieces.


o Dinner: Grilled fish or chicken with mixed vegetables, wild rice, and fruit.


o Snacks: 1 oz. almonds and popcorn.


o Desert: Coconut Ice Cream or fruit. 


Tips


1. Be patient with yourself. You'll have days when being gluten-free is really depressing (maybe even "fall off the wagon"). This is normal.


Relax – it’s a process.


2. Carry snacks with you wherever you go. It's often difficult to find an appropriate snack when the hunger strikes. GF bars are great! 


3. Arrange with the hosts of gatherings you may attend to bring your own sides or complete meals. Most people are very supportive of restricted diets.


4. Carry a small cooler in your car with small cold packs to store fruit, snacks and water


5. Consider avoiding restaurants during your transition phase as you learn how to eat and think gluten-free. Grilled meats (over a flame), baked potatoes and salads without croutons are usually safe bets. But keep a log of places you eat, what you ate and how you felt afterward. Gluten is insidious and can turn up in the oddest places (french fries, for example which can be dusted with flour).


6. Get your hands on cookbooks or start collecting your own recipes in a binder. 


7. Carry digestive aids (enzyme and bioflavonoid) with you in case of accidental ingestion. There are ones specifically for gluten such as GlutenFlam by Apex Energetics; available from your healthcare practitioner.


8. Consider taking a multi-vitamin to make up for vitamins and minerals you may lack with your new diet (ask your doctor or nutritionist if necessary).


9. Find a mentor or support system.


10. Breathe


About the author: Sandi Star, CCN


Sandi is the founder of Karmic Health, specializing in nutrition related to disease where a gluten and casein (dairy) free lifestyle is crucial; working with celiac, autism and all auto immune disorders. Sandi graduated from The Natural Healing Institute with a degree in Clinical Nutrition and is continuing her studies in Clinical Herbology. She has hands on understanding of many health issues and has dedicated her life in helping others reach their optimal health.


For more information related to this article please visit www.karmic-health.com or contact Sandi Star at 760.685.3154


© Copyright Karmic Health 2010


Starting a gluten free diet

Oct 7, 2009 by Anonymous

I think that it is good to purchase a book describing a GF diet before embarking on the diet. You may also want to consult with a nutritionist who can advise you on how to modify your family’s current eating to make it GFCF. You can also look to find another mom in your community who is doing it. Many of my mom friends are GFCF. I think if you hang out with another mom who is making those choices, you will realize that it is not so hard.

I (and others) can answer your questions online, but you may have to see it in practice in order for it to seem less intimidating.

In my experience, there are three approaches. My approach is to give up processed food and shop the periphery of the grocery and get food from farmer’s market/local farms. I serve protein, vegetables, and fruit. I cook every night and serve simple tasty food. This is relatively easy and works for me.

Other moms are very impressive and do what I do plus they bake fabulous things using nut flours, etc. I have tea once a week with a good friend who bakes the most extraordinary GFCF muffins. She does this every morning for her family!

The third category is represented by Jenny McCarthy. Sure, she serves her kid fruit and stuff, but mostly she seems to rely upon GFCF processed foods that are available in Whole Foods, Trader Joe’s and specialty grocery stores.

You probably need to figure out where you fit in these three categories and then just give it a try.


Drinking buddies

Aug 31, 2009 by Anonymous

Well, I was worried about the wrong kid.
How long did we wring our hands and experience gut-wrenching anguish over Thomas’ surely difficult and confusing transition to all-day, eat-lunch-at-school first grade? On the first day of school, he kissed me goodbye and walked in the building. Okay, so long! See you later! Hayley, on the other hand, was rather upset, sobbing loudly. I have a bit of a dilemma on my hands that I have to drop Hayley off at the Kindergarten entrance and Thomas gets dropped off at the First Grade entrance. So on the first day, it was pouring outside (naturally) so we had to walk into the hall. I left Hayley, who wasn’t listening to me and when I told her that I’d be right back after I found out where Thomas needed to go. I walked about ten feet away when I heard her crying. One of the aides who knows Thomas offered to take him to his class so that I could stay with Hayley, which I did, until it was time for me to leave her. She was crying – loudly and a lot.
Jonathan and I were completely confused by this behavior. Hayley had been in that classroom once every week for the past school year! However, Jonathan made the sensible point that I had been with her the whole time she was there. This was the first time I left her there. Okay, that makes sense. Anyway, Hayley stopped crying shortly after I left and ended up having an okay day. Since it rained for the first three days of school this year, Jonathan was able to pick up the kids with me which was nice for him and the kids. Thomas was very excited to see Jonathan after his first day of school. We immediately noticed that Thomas had forgotten his lunch box and home folder so we had to go back in for them. His teacher said that he did a fine job and the social worker said that the few times she poked her head in the room, he was doing great. So Thomas is off to a surprisingly smooth start. Of course, I remember last year when there was a “honeymoon period” right at the beginning of the year and then things went downhill a bit. I might be remembering a couple years ago when Thomas was in preschool. I don’t know. I just hope we keep grooving like this.
Thomas is doing fine eating lunch at school, although he rarely finishes. I guess he eats like Jonathan – slooooooowly. Most days, he brings his bag home with leftovers. He always asks for a snack when he gets home which is not that weird – most kids have after-school snacks. But I hope he’s getting enough time to eat. Rather, it’s probably that he doesn’t stay focused and eat when it’s time to do so. He might be socializing with the two girls he sits next to. Anyway, he likes recess and he likes eating lunch at school. We’ve managed to put other edible (to Thomas’ standards) items in his lunch box so that we don’t have make pizza every night to put in the lunch box the next day. He eats chicken nuggets and chicken sandwiches too. We put a juice pouch or chocolate milk in there along with maybe a granola bar and fruit snacks. The fruit snacks are always finished when we get his lunch bag back. It’s usually the nuggets, pizza or sandwich that is half-eaten.
Part of the program in first grade is learning to read, so we have to read with Thomas for twenty minutes every night. I have modified this program to reading one book at night. Making Thomas try to do anything he doesn’t enjoy for twenty minutes is frustrating for him and us. He’s able to recognize words when prompted, so he’s got a good foundation. I just wonder when he’s going to start trying to sound out words on his own. He makes the word sounds but doesn’t put them together. And then there’s Hayley, who’s prone to know-it-all-ism, hanging over my shoulder, shouting, “Mommy! I know that word!” It’s hard getting her to keep quiet while I’m trying to get Thomas to read. I’ll have to put her in her room while we’re trying to read from now on.
It’s hard, too, to try and get everything ready for school on nights when I work. I try to get lunches made and homework done before I go to work at 5 p.m. But I suspect I’m preaching to the choir of my readers here…I don’t even work full-time, so I have little room to complain about trying to keep everything running smoothly. Things are going well for me at work, though. They really seem to like me and I won Employee Of The Month while we were in Florida and they want me to start training new people as a “Neighborhood Expert” which I am not officially yet as I have to attend some sort of “expert camp” or retreat or something before. At least it’s nice to be appreciated.
One funny story and then I’m off to collect Hayley from school: The last time the kids were at the cottage, they went out for ice cream. Hayley and Grandma ordered the same flavor, so Mary said that they were “ice cream buddies.” Fast-forward to this past Friday when Hayley and Thomas both chose to have grape Kool-Aid for dinner. Hayley looked at her cup and his and declared, “Thomas! Look! We’re drinking buddies!” Jonathan and I laughed until there were tears in our eyes.


Summer vacation cometh...

May 30, 2009 by Anonymous

I’ve been getting that scary and nervous end-of-the-school-year feeling. Hayley finished pre-school over a week ago – yes, and graduated with flying colors. I know that Hayley is very well-prepared for kindergarten at this point. She’s already sounding out words and tries to read things we encounter every day (she sounded out “sewer” on a manhole the other day and we got into a long discussion about exactly what that was) and she’s been in Thomas’ class every Tuesday all year. She knows her teacher, the classroom and the classroom routine, so I have absolutely no worries there. That’s great, right? One less thing.
Thomas has been slipping into his alter-ego in the evenings lately; we call him “Super Crazy-Man.” He gets pretty wild and goofy and then alternately affectionate and loving. I think it has something to do with good weather finally coming to Chicagoland and him being able to spend more time outdoors. Soon, if there’s a day in the eighties, we’ll make our first trip to Uncle Tom’s pool, something the kids are very excited for.
Another thing I’m hoping for this summer is more “play-dates” with a nice family we’ve made friends with over the past school year. Thomas has a classmate who has a little sister that’s Hayley’s age and she actually came over to play one day last week while the boys were at school. This family is non-traditional in that the father stays home with the kids and the mother, who is an international flight attendant, works. They have three kids (their youngest, a girl, is two) and the dad is on his own with all three kids for days at a time while his wife is completely out of the country. Yikes! But here is a rare person of the opposite sex who understands what being a stay-at-home parent is like, what hard work it really is, and he has a tougher job than most stay-at-homers. So I’m hoping that over the summer, we can swap kids from time to time. I know he feels like he could use a break sometimes, Thomas and Hayley like playing with his two oldest kids, and his two year-old is a doll. She actually really likes other people to hold her, especially Jonathan for some reason. Hopefully they’ll come over more often over the summer and maybe we can go swimming together or something. But I really think it’s important for the kids to have playmates (this other family lives close enough for us to walk to their house) for many reasons, not the least of which is that I can’t play Barbies with Hayley much more before I lose my mind. The fact that she keeps asking me has made it very clear that these kids need friends to play with. Thomas has never had a friend over to play, nor has he been invited to anyone else’s house, so it would be a cool experience for him and I’m wondering how he’ll react. I’m kind of worried that we’d have this boy over to play and that Thomas would play with the PSP the whole time rather than engaging with his friend. Only one way to find out, I guess.
So the end of the year approacheth, along with all of the year-end activities it entails. Thomas’ “graduation” is on June 8 and his last day of school is June 9. He’s still unenthusiastic about first grade, but he’ll meet his teacher and see his new classroom soon which should help. The biggest hurdle will be the whole “eating lunch at school” thing. We have two choices: I can either pack lunch for Thomas everyday or we can purchase the school lunches for him. I’m not what you’d call a “health nut,” but I am a fan of good nutrition and I don’t really have any idea what the school lunch entails. On the other hand, Thomas has announced that he wants me to make pizza for his lunch every day. So I’d be spending every evening making pizza, sticking it in the fridge and putting cold pizza in his lunchbox every morning. We’ve been trying to figure out a sandwich that he would eat, since sandwiches are much more packable and convenient, but we have so far come up clueless. We’ll have to do a lot more thinking about it this summer.
Yes, at this time each year, I begin wondering when I’m going to get the grocery shopping done every week. And even though I didn’t mention it this time, we’re still really excited about Disney World, rest assured. 69 more sleeps until we go.



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