Aripiprazole treatment may help to decrease violence and increase physical activity in people with autism.
The authors of this paper define challenging behavior as "behavior of such intensity, frequency, or duration that the physical safety of the person or others is likely to be placed in serious jeopardy." The paper describes the effects of aripiprazole therapy on challenging behavior in five people, one of whom has autism. The patient with autism was a 38-year-old Afro-Caribbean man with severe intellectual disabilities. Before starting the study, he was given risperidone (3 mg twice daily) and chlorpromazine (100 mg three times a day) and had gained 150 pounds in 2 years. During the study he was given aripiprazole (15 mg/day) and gradually taken off of risperidone. He was less violent and more alert on aripiprazole, and he lost about 30 pounds in two years.
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Come sail away...
May 29, 2008 by AnonymousWith Memorial Day behind us, the summer season has officially begun. You wouldn’t know it if you were here, though. The weather has been so cool that it feels more like early April than late May. We went up to the cottage for the weekend, though, where Thomas made memories of staunch boat-riding refusals a thing of the past.
We were in the garage on Saturday afternoon and Thomas noticed the peddle-boat that my mother-in-law bought last year. Thomas asked what it was, I told him, and he requested that it be brought down to the water so that he could ride in it! Same kid as last year, remember, who wouldn’t even go near the water except to point out that he didn’t like it and wanted nothing to do with it. Jonathan and his brother carried this little 4-person (well, 750 pound capacity, anyway – four grownups would probably capsize it) peddle boat down to the water. I figured that it would be great if Thomas would ride in it because it involves physical activity and it’s not all that much different from his peddle car. He got in, I got in, Hayley got in and even Sophie got in and we peddled around the little bay very merrily indeed. Thomas really loves it! I love it too because the boat is so small that I don’t need any help getting it away from the pier or getting the kids (and the dog) on the thing or off of it, and it’s great exercise. Thomas requested that a grown-up take him out in the peddle boat several more times during the weekend.
The real triumph came on Sunday. When a father has a son, he dreams of many things they’ll do together: play catch and t-ball, watch football on Sundays in the winter and, in Jonathan’s case, ride the waverunner together in the summer. We bought the thing about 16 months before Thomas was born, so it’s been in our family longer than he has. Ever since we found out that Thomas was a boy, Jonathan has been dreaming of sharing the joys of waverunnning together. This past weekend, he finally got his first chance. After we replaced batteries and sparkplugs, cried as we filled the watercraft up with gas (the BEST reason of all to use the peddle boat!) and launched the waverunner, Thomas announced that he wanted to ride with Daddy! And he did! He didn’t want to go very fast, but he did ride it around the bay slowly with Jonathan and he really liked it! We just can’t believe the complete turnaround from last year – who is this child? All of a sudden, Long John Silver found his sea legs and his grandfather would have been so proud!
The rest of the weekend was pretty good too, except for the big pine tree falling on everyone’s cars. There were severe storms in Madison on Sunday night and they blew what was apparently an unhealthy and also huge pine tree down right across the windshields of our cars and the garage doors at the cottage. This whole thing turned out to not be a big deal, but it disturbed Thomas a little bit. We had just walked back inside after getting home from a friend’s house for dinner and two minutes later, a neighbor knocked on our door an told us that a big tree fell on our cars. I think that Thomas didn’t understand what was going on but was reacting to the intensity of everyone’s voices. He was saying that he wanted the tree to fall on our “old truck so that we could get a new one.” He was getting upset and confused, so I took the kids out to see the tree which had broken off about six feet from the ground. The tree being so far out of place seemed to agitate Thomas even more, so I said that I didn’t think we should talk about it anymore until the next morning.
The next day, everything was a little less serious since the storms had moved on and the sun was shining. Thomas wasn’t nearly as upset about it anymore, and the tree helped keep the kids out of the driveway and away from the cars. The latest official report said that the tree will be gone tomorrow, and all will be right with the world.
Tomorrow, I plan to call Thomas’ new kindergarten teacher for next year and see if we can come and visit one day next week. We’re having a tough time at home since school ended. The change in routine for Thomas is difficult for him to digest, but once he gets used to it, things should improve. This seems to happen every year at the beginning, end and during Winter break. Thomas has just been very energetic at home and he has a difficult time following instructions and staying calm. He plays too rough with Hayley (but she doesn’t mind) and is very loud. I’m hoping that vacation on June 7 will help take the wind out of his sails, so to speak, and we can settle into some kind of summer routine.
Tennis, anyone?
Apr 15, 2008 by AnonymousFinally, the weather is improving! We’ve been spending a lot more time outside playing in the yard and walking to the park. Last year, it seemed like no matter how old Thomas got, I’d still be strapping him into a stroller or making him sit in the wagon to take him to the park. It’s really amazing how much things can change in what seems like no time at all.
Thomas loves to ride his little pedal car to the park. The only problem is that riding the pedal car is all he wants to do when we get there. Hayley wants to play on the slides or the swings but Thomas wants to keep on truckin’. So we go on to the next park and the next (there are three nearby that are all connected by paths) and by then Hayley has seen a flying bug and it’s all over; we have to go home immediately. We saw a very sluggish and sleepy bee on the ground at the park yesterday and Hayley flipped out. (I was rather surprised to see a live bee this time of year too, as a matter of fact.) She is suddenly quite imprisoned by her intense and irrational fear of bugs and it’s worrying me for the coming summer. I’ve tried explaining to her that bugs are important to trees and plants and that bugs live outside and we have to get along with them when we’re outside too. Not much of that is sinking in. I hope she can get over it before summer really gets going. Our family vacation will be one very long week if she doesn’t.
So Thomas pedals to the park, being careful not to get too far away from me – and I can trust him to not run away! (Or pedal away, as the case may be.) Tomorrow it’s supposed to be even warmer and I suggested tonight during baths that we go to a different park. I’ve seen some other neat-looking parks on my jogs and I hope we can try some of them. Thomas is ill-disposed, however. He said that we shouldn’t go to different playgrounds; “that wouldn’t be too much fun.”
Tomorrow is Spring Picture Day at school and I can’t wait to see the kind of picture Thomas brings home. He’s been very into having his picture taken lately. I’ve been selling a lot of old clothes on eBay as I lose weight, and every time I get the camera out to take snaps of these items, Thomas insists that I take a picture of him and then show it to him. It hit me that Thomas and Hayley will never know a time before digital cameras! They’ll never fool around with film and flashcubes (I’m only just barely old enough to remember flash cubes, I swear!) and waiting four days for film to be developed only to find out that Aunt Maude had her eyes closed in every single picture of her at Uncle Joe’s retirement party.
Which brings me to another aspect of life that our children will never remember in its original form: We located and purchased a Nintendo Wii this weekend. Jonathan and I really wanted one (Happy Mother’s Day to me; Happy Father’s day to him) not just for us but for the whole family. I like it better than the average game system because most of the time, you’re standing up making wild, gesticulating motions as you pretend to punch with fists, poke with an epee, display a blazing backhand or perfect a breaststroke. We were playing yesterday and I remember wondering what an alien would think if they were to watch us through our windows as we had what looked like severe seizures in front of the TV. Anyway, the point is that there is more physical activity and coordination required to play this Wii system. You would not believe how much my biceps hurt yesterday from that tennis game! I think those are biceps…anyway, Thomas loves it, too! He is actually really good at the tennis game and Hayley likes to play golf. Thomas laughs so hard when his little character waves the tennis racquet and admittedly, he’s only really able to volley the ball because he’s always moving and therefore his character is always swinging, but he likes it and that’s what’s important. There’s a little “Mii” section of this system where you can create the characters you play with, from the height and body type to face shape, hair color and pretty much every aspect of someone’s appearance. So we made characters for our whole family, plus the kids’ aunts, uncles, cousins and grandparents. I showed Thomas and Hayley and now they like to see who’s in the stands for tennis, who’s watching at the bowling alley and who’s on their baseball team. It’s very cute! I’m hoping that as they grow, they’ll get better-coordinated with the Wii. We bought a couple games we thought the kids would be better at, but even those were too advanced. I’m going to try to find some games that are rated “EC” for “early childhood.” Those would almost certainly be more appropriate, educational, and easy-to-play. One thing’s for sure: They’ll never remember Atari cartridges and joysticks.
Thursday or Friday, I have to go to kindergarten orientation and I feel rather unprepared. I’m not sure if they’re going to have childcare available – and I don’t know if our home school is even the one Thomas will be attending next year. If our grade school doesn’t offer an MLP class, he’s going to be bussed somewhere else. I’m going to have to call his school or our elementary school tomorrow to find out what I’m supposed to do. We’re not going to decide on Thomas’ placement until May 6, and even then we could change our minds over the summer.
We’re going to the cottage this weekend to put the pier in the water. After we were there two weeks ago, I really don’t dread it. The kids are so good up there now that this is finally the year that things get better! We’ve been waiting for it and now it’s here. Undoubtedly, God will jar me out of my reverie somehow – like I’ll get pregnant or something. (I’m not pregnant, mom. That was a joke.)
SpiritHorse Therapeutic Riding
Sep 17, 2007 by AnonymousSpiritHorse therapeutic provides free, private equine-assisted healthcare in our award winning programs to over 450 children with disabilities each week at our facilities just north of Dallas, Texas. One hundred-sixty of these children have been diagnosed with autism spectrum disorder.
We provide healthcare rather than the customary recreation the therapeutic riding industry is known for. We have developed eleven specific methods for intervention with autism and an instructor who is our autism specialist. These methods are based upon the elements of Alternative Behavior Analysis the Developmental, Individual Differences, Relationship-Based method (DIR Floortime) and the knowledge that specific physical activity can create neurological changes. We have a distinct advantage in crossing the first hurdle of DIR/Floortime which is finding something with which to engage the child. Children love ponies. We have been very successful in developing experience sharing with the rider, their parent, the pony, and their instructor.
One beautiful day this spring Nathan (a five year old boy with autism who has learned to speak since coming to SpiritHorse) was riding Fudge along the trail with his instructor Nikki leading and his mom walking alongside. He reached out and took his Mom's hand and said: "I love you mommy". We believe that he did this because the experience was so wonderful that he just had to share it. When his Mom regained control she tearfully said: "That is the first time he ever told me he loves me". These things happen often at SpiritHorse.
Using these methods we have developed, we have heard thirty-one children with autism speak their first word on one of our ponies.
We have discovered that our riders with autism prefer to turn left rather than right. Our medical advisory board is of the opinion that this is because the right hemisphere of the brain develops first and when the left hemisphere starts to develop, its development is delayed with the onset of autism, and of course the less developed left hemisphere controls the right side of the body. Incidentally, language comes from the left hemisphere and this developmental delay of the left hemisphere is the reason that many children with autism have delayed language.
We performed a pilot study with five riders with autism doing a sitting trot in a twenty foot circle a total of 60 counter-clockwise and 60 clockwise revolutions. We recorded only two incidences of unbalance in the counter-clockwise direction and a total of twenty-eight incidences of unbalance in the clockwise direction. We also noticed a significant number of negative non-verbal reactions in the clockwise direction. After twelve weekly lessons, all of these children were balanced in both directions with no negative non-verbal responses. Our medical advisory board is of the opinion that we are building synapses (circuits that make the brain function) in the left hemisphere through the work in the clockwise direction, and thereby reversing autism to some degree.
We also performed a study of five of our children who do not have a diagnosis of autism and they were equally balanced in both directions at the outset.
Additionally, we conducted a pilot study by having five children with a diagnosis of autism weave in and out of a line of traffic cones. We found that these children missed five times more right turns than left. The left hemisphere, most affected by autism, did not respond well on the right turns. Very interestingly, we noticed a two to three second delay in the movement of the right arm when turning right, enough delay that a cone was often missed.
After twelve weekly lessons, these children missed very few turns and neither direction was predominate. Very interestingly, the delay in the movement of the right hand for right turns disappeared. Our medical advisory board believes that we are reversing under-connectivity with this exercise.
Following the lead of Temple Grandin who invented the "squeeze machine", we use riding safety vests strapped very tightly to help our riders with autism who have difficulty in regulating. These vests are very different from the weighted vests often used for children with autism. The weighted vests place pressure on the shoulders, while these vests are adjusted to place pressure on the trunk, more like Temple Grandin's machine. For those with this symptom the results are often dramatic.
The impact of our methods for children with autism has been under study by the University of Texas Southwestern Medical School for over one year. Dr. Janet Kern, assistant professor of their Department of Psychiatry commented: "The preliminary results are excellent".
SpiritHorse has just reached an agreement with the University of North Texas Biofeedback/Rehab Department to perform EEGs and brain mapping on our riders with autism before and after each lesson. Through these tests they can objectively measure many brain functions, including under-connectivity. They will also measure rhythm, which a recent study showed its development to be an intervention with autism. We develop rhythm to a maximum degree in our riding program.
With these measurements we hope to further refine and develop additional methods for intervention with autism. We also have plans to provide free training to therapeutic riding instructors from around the world to develop autism specialists that will change programs at other centers from recreation to healthcare.
SpiritHorse was awarded the coveted Dallas Ft Worth Alliance for Healthcare Excellence Servant Leadership Award for 2006 for: "High quality, affordable healthcare in the North Texas Area". The award was won by Baylor Hospital Systems in 2005 and Parkland Hospital in 2004. We are very proud to have been recognized by North Texas health professionals for our work with children with autism.
Charles I. Fletcher
Founder/President
SpiritHorse Therapeutic
Riding Therapy
Aug 20, 2007 by AnonymousI have had such tremendous luck with rding therapy. My son (Prader-Willi Syndrome) has been up on a horse since he was 1 year old. At three, he can ride in jump position for 20 minutes (which says a lot about his strength and balance!). He now receives hippotherapy twice a week.
There are many places where you can get riding therapy. I think it is worth calling your local stables and seeing if they can make recommendations. To see an example of a hippotherapy riding center, look at the Web site for the SpiritHorse Therapeutic Riding Center (www.spirithorsetherapy.com).
SpiritHorse Therapeutic provides free, private equine-assisted healthcare in our award winning programs to over 450 children with disabilities each week at our facilities just north of Dallas, Texas. One hundred-sixty of these children have been diagnosed with autism spectrum disorder. We provide healthcare rather than the customary recreation the therapeutic riding industry is known for. We have developed eleven specific methods for intervention with autism and an instructor who is our autism specialist. These methods are based upon the elements of Alternative Behavior Analysis (ABA), the Developmental, Individual Differences, Relationship-Based method (DIR/Floortime) and the knowledge that specific physical activity can create neurological changes. We have a distinct advantage in crossing the first hurdle of DIR/Floortime which is finding something with which to engage the child. Children love ponies. We have been very successful in developing experience sharing with the rider, their parent, the pony, and their instructor. One beautiful day this spring Nathan (a five year old boy with autism who has learned to speak since coming to SpiritHorse) was riding Fudge along the trail with his instructor Nikki leading and his mom walking alongside. He reached out and took his Mom's hand and said: "I love you mommy". We believe that he did this because the experience was so wonderful that he just had to share it. When his Mom regained control she tearfully said: "That is the first time he ever told me he loves me". These things happen often at SpiritHorse.Using these methods we have developed, we have heard thirty-one children with autism speak their first word on one of our ponies. We have discovered that our riders with autism prefer to turn left rather than right. Our medical advisory board is of the opinion that this is because the right hemisphere of the brain develops first and when the left hemisphere starts to develop, its development is delayed with the onset of autism, and of course the less developed left hemisphere controls the right side of the body. Incidentally, language comes from the left hemisphere and this developmental delay of the left hemisphere is the reason that many children with autism have delayed language.We performed a pilot study with five riders with autism doing a sitting trot in a twenty foot circle a total of 60 counter-clockwise and 60 clockwise revolutions. We recorded only two incidences of unbalance in the counter-clockwise direction and a total of twenty-eight incidences of unbalance in the clockwise direction. We also noticed a significant number of negative non-verbal reactions in the clockwise direction. After twelve weekly lessons, all of these children were balanced in both directions with no negative non-verbal responses. Our medical advisory board is of the opinion the we are building synapses (circuits that make the brain function) in the left hemisphere through the work in the clockwise direction, and thereby reversing autism. We also performed a study of five of our children who do not have a diagnosis of autism and they were equally balanced in both directions at the outset.Additionally, we conducted a pilot study by having five children with a diagnosis of autism weave in and out of a line of traffic cones. We found that these children missed five times more right turns than left. The left hemisphere, the side most affected by autism, did not respond well on the right turns. Very interestingly, we noticed a two to three second delay in the movement of the right arm when turning right, enough delay that a cone was often missed. After twelve weekly lessons, these children missed very few turns and neither direction was predominate. Very interestingly, the delay in the movement of the right hand for right turns disappeared. Our medical advisory board believes that we are reversing under-connectivity with this exercise.Following the lead of Temple Grandin Ph.D. an individual who has been dagnosed with Asperger's and who invented the "squeeze machine", we use riding safety vests adjusted very tightly to help our riders with autism who have difficulty in regulating. These vests are very different from the weighted vests often used for children with autism. The weighted vests place pressure on the shoulders, while these vests are adjusted to place pressure on the trunk, more like Dr. Grandin's machine. For those with this symptom of autism the results are often dramatic.The impact of our methods for children with autism has been under study by the University of Texas Southwestern Medical School for over one year. Dr. Janet Kern, assistant professor of their Department of Psychiatry commented recently: "The preliminary results are excellent". SpiritHorse has just reached an agreement with the University of North Texas Biofeedback/Rehab Department to perform EEGs and brain mapping on our riders with autism before and after each lesson. Through these tests they can objectively measure many brain functions, including under-connectivity. They will also measure rhythm using the Interactive Metronome. A recent study showed the development of rhythm to be an intervention with autism. We develop rhythm to a maximum degree in our riding program. With these measurements we hope to further refine our methods and develop additional methods for intervention with autism. We also have plans to provide free training to therapeutic riding instructors from around the world to develop autism specialists that will change programs at other centers from recreation to healthcare.SpiritHorse was awarded the coveted Dallas/Ft Worth Alliance for Healthcare Excellence "Servant Leadership Award" for 2006 for: "Thje highest quality, affordable healthcare in the North Texas area". The award was won by Baylor Hospital Systems in 2005 and Parkland Hospital in 2004. We are very proud to have been recognized by North Texas health professionals for our work with children with autism. Charles I. FletcherFounder/PresidentSpiritHorse Therapeutic