Autism Therapy: routine

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Child and Adolescent Psychiatric Clinics of North America, by de Martinez-Peraza, F. L., and Carter AS, published in 2009, summarized Feb 12, 2010

Early diagnosis of autism may lead to effective early intervention.

This review article gives an overview of diagnosis, testing, and therapy options for children with autism. Details focus on children with autism or pervasive developmental disorder-not otherwise specified (PDD-NOS). Autism may be diagnosed based on problems with social interactions and communication. A child with autism also may have repetitive behaviors. The Academy of Pediatrics recommends routine autism screening between 18 to 24 months of age. Early intervention therapy may be designed to offer the best chance for learning at each stage of development. The authors suggest that physicians monitor younger brothers and sisters of children with autism for symptoms of autism. Therapists and physicians may also consider that parents face more stress when faced with an autism diagnosis for their child and suggest family therapy for the parents.


Focus on Autism and Other Developmental Disabilities, by Gillis, JM, Natof TH, Lockshin SB, and Romanczyk RG, published in 2009, summarized Jan 22, 2010

Children with autism may fear physical exams at the doctor’s office, and their fears may be reduced with behavioral therapy.

This study asked parents about their child’s reactions to specific medical instruments and office visit procedures. Most of the children with autism in this study (11 out of 18) were extremely upset during blood draws. Some (10 out of 23) were upset or extremely upset when someone examined their throat. Some children reacted when specific instruments were used (for example, a thermometer or stethoscope). To help children feel more comfortable, behavior therapy, such as applied behavior analysis (ABA), was performed for about 7 to 10 months. Children were very gradually introduced to the process of the physical exam, and given a reward when they did not show fear at each small step. The process continued until the child could go through the entire exam. After therapy, 10 out of 14 children who completed the process had no fears of medical exams, and 4 had fears of one piece of equipment.


Autism, by Stephens, CE, published in 2008, summarized Jun 22, 2009

Imitating musical play routines of children with autism may help increase their social interactions.

Imitation is an important way for infants and children to learn to interact socially with other people. Four children (5-8 years old) with autism were given musical instruments that matched ones the therapist had. They used tambourines, castanets, blocks, rhythm sticks, and maracas to imitate simple lively music. The music therapist gave either verbal praise or imitated the child's actions when the child played, danced, and/or sang. When the music therapist imitated the children's behavior, the children were more active and responded to the therapist.


British Medical Bulletin, by Tantam, D., and Girgis S., published in 2009, summarized Apr 2, 2009

Social skills training, psychotherapy, and behavioral training such as applied behavior analysis (ABA) may be helpful for people with Asperger syndrome.

This review article describes treatments for people with Asperger syndrome. The authors use the term patient management and state that diagnosis is the most important part of management. Once diagnosis is made, then the patient may also be screened for other problems such as hearing or vision problems, or seizures. IQ tests may help doctors to suggest a path of schooling or work. The authors do not believe in the routine use of drug therapy for people with Asperger syndrome.


Denise Reynolds, a registered dietician, has provided some good suggestions for toilet training your child with autism. She reminds parents that there are milestones that must be reached before a child can be toilet trained, for example, knowing how to dress and undress, understanding the bodily clues needed to use the bathroom, and walking. She explains that sometimes kids with autism have gastrointestinal problems that need to be addressed before successful toilet training. She quotes from an referenced article by Danica Mamlet, Autism and Toilet Training, for motivation cues and potential social integration issues. “A system that uses picture icons with each step identified is recommended as a tool to teaching toilet independence. A consistent routine capitalizes on the autistic’s child need for repetition.” Other tips include a transition object such as a book or a toy and teaching your child words specific to the bathroom so he can communicate. Reynolds’ final reminder is that each child has his own timetable and some children take longer than others to toilet train.

Read original article: Potty Training Tips for An Autistic Child


This article highlights two new tools recently provided by Autism Speaks. The Sleep Strategies Guide and the Tool Kit for Dental Professionals can be found on the Tools You Can Use page. The Sleep Strategies guide is organized so that parents can begin simple changes in their child's bedtime routine, in order to make it easier for the child to go to sleep and stay asleep. The Tool Kit for Dental Professionals helps dentists and hygenists learn to understand and work better with the autism population. Both aids are available for free download.

Read original article: Autism Speaks Provides Sleep Strategies and Dental Treatment Toolkits


Kathie Harrington, a speech and language pathologist and mom of a son with autism, has written an article on dealing with anxiety. She points out that anxiety in a person with autism may affect sensory, physical, imagined, and communication areas in the person’s life. She explains, “They are anxious when they know and they are anxious when they don't know. They are anxious when they see something is close and they are anxious when something is not close enough…. They are anxious when, and when, and when... .” Some techniques she recommends include routine, relaxation, weighted clothing, music, flashlight, View Master, bean bag chair, and reading.

Read original article: How to Ease Anxiety in a Person with Autism/ASD


This article by special education teacher, Pamela Gross Downing, offers some tips on transitioning back to school after summer vacation for kids with autism. Many children with autism become accustomed to their summer routine and parents are encouraged to prepare children in advance. One suggestion is to begin waking the child a little earlier each morning. Another tip is to drive by the school, show your child his or her new classroom, and if possible meet with the teacher. A picture schedule of each day’s activities can be placed where the child can see it. He or she is able to get used to the order in which things will happen – get up, eat breakfast, get dressed, drive to school, etc. Parents can get out school supplies and let the child become familiar with them. Downing reminds parents that as much as they prepare, there may still be struggles in the beginning.

Read original article: Transition to School Important for Children with Autism



Please comment on this autism topic.

A magical vacation...

Aug 20, 2009 by Anonymous

Okay. Here goes.
We had a wonderful vacation. I can only say that now, a few days later, after I’ve been given time to ponder and reflect. I wrote a blog on the airplane home, but after reading it now a few days later, I think it was a little harsh so I’m doing a re-write. I liken it to childbirth. After the baby is out and you’re thrilled to be a parent, you don’t really remember the agony of it all. You even start thinking about when you’ll have another one.
To be honest, most of the trip was exhausting to us. We learned a lot, which is a good thing. We’ll do things a bit differently next time, whenever that turns out to be. We think the kids had a great time; at least they’re saying that they did now. They were not very well-behaved for a large portion of the vacation. In fact, Donald Duck himself had to break up a fight between Thomas and Hayley at Chef Mickey’s at the Contemporary Resort. We were suitably mortified, I can assure you. We were, needless to say, disappointed in the kids and their behavior. We had hoped that they would be magically wonderful, since every Disney employee we ran into wished us a “magical” day. Even when I called the front desk for extra towels, I was wished a “magical” evening. I should have asked for “magical” towels.
There were two main pieces of advice that we received prior to our vacation that we should not have taken as gospel truth. The first was that autistic children can improve dramatically (magically!) while at Disney World. I really thought that this would happen for Thomas, since he is one of those kids who requires more stimulation than other kids. And Disney World is sensory overload extraordinaire. I’ll just say that Thomas has never acted more autistic in his life. I was quite disappointed. I’m not saying that I thought we’d spend ten days (too long, by the way, but more on that later) in Disney World and come home with a cured boy, but I at least thought that he might be better while on vacation. He was worse. And his badness rubbed off on his sister. Hayley copped an attitude most of the time which I’m sure has nothing to do with the fact that every Disney employee who crossed her path called her “princess.” I was called princess a couple times, but I know I’m not a princess. Trust me, I know. For Hayley, the jury in her brain is still out.
The second thing that we were told to do over and over again by everybody we talked to was to take a break in the middle of the day. Go back to the room, go swimming, take a nap, have a snack, re-charge the old batteries and then go back to the parks in the evening, fresh as daisies. Here’s what happened to us: We got on the bus to go back to the hotel, and during the bus ride the kids fell asleep. We made the trek back to the hotel room where the kids, having rested quite enough on the bus, would be bouncing off the walls just as Jonathan and I wanted to curl up and take a nap. Ha! So we maybe would take them swimming or watch cartoons for a while and then head out again. So this way, the kids were great for the rest of the day but Jonathan and I were completely frazzled and every little thing the kids did wrong set us off. The grown-ups were the cranky ones by day’s end. So some of the best days we had were ones where we went all day long, taking for our “break” a sit-down meal for lunch.
Despite our “go all day long” routine, I managed to pack on twelve pounds! Yes, despite walking around in the hot and humid Florida sun, sometimes toting a child on my back, I managed to gain several pounds over the course of the ten days. I can sum it up in two words: brownie sundaes. We did the basic Disney Dining plan which included one snack, one “quick-service” (fast food) meal and one sit-down table-service meal per person per day. Both the quick-service and the sit-down meal included a dessert for adults. Well, what are you supposed to do but order the dessert and scarf it down? We’d already paid for it! Next time, we think we’ll skip the dining plan, although it was very nice not to have to budget for food which can be a very inexact science. The food was all paid for before we left so that any extra money we brought could be used for incidentals and suchlike. We actually spent very little cash because we didn’t have to pay for food while we were there.
Again, in hindsight, it was a wonderful vacation but not without its ups and downs. We thought the kids would be better than they were. At the end of the trip, we decided that the kids were still a little too young to truly appreciate what they were enjoying. I don’t mean that we expected them to sit us down, look us in the eyes and say, “Mom, Dad, we know just how great an undertaking this has been for you, we understand the cost involved and we truly appreciate everything you’re doing for us. We will always treasure this time with you in our memories.” I don’t think I’ve even said that to my own parents now, who took us all to Disney World when I was in eighth grade. I can say that I have a huge appreciation for them having done it, and I understand what kind of planning and budgeting went into it.
Also, as I hinted at before, ten days was just straight-up too long. Next time, we’ll stay for maybe a week and get better accommodations. The All-Star Movies Resort was fine, but it was clear that it was Disney’s version of the nosebleed section given its proximity to the parks and the clientele. It was rather noisy and we dealt with rude people a lot. Really, at Disney in general, it’s every family for themselves, and those who realize this sooner rather than later will have a better time in general. Jonathan and I, being pushovers, care about other people’s feelings and were shocked at some of the rudeness we witnessed.
So next time – this hypothetical “next time” – we’d stay for shorter in a better hotel, rent a car so that we weren’t constantly at the mercy of the Disney Bus System and ditch the dining plan so that we could eat (less) outside the World and probably spend less. Everything at Disney is so expensive! I read that Disney will ride a money horse until it drops and boy, was that ever true! Plus, if you do the Dining Plan, Disney’s got you – all your money and you’re never leaving the parks until they shuffle you onto the bus to the airport and drop-kick your luggage to its final destination, and they don’t really care where that might happen to be. Our bags did show up, but somewhat smashed.
So that was our trip. If you have any questions, let me know. Now, we gear up for school! Hayley had her kindergarten assessment with Mrs. H. yesterday and she did a swell job! Pre-school really paid off in that respect. After her little interview, we went and visited Thomas’ new classroom and saw his teacher again. After seeing his teacher and class again, Thomas is much more…okay…with going to first grade. Plus, I told him that I’d make him cold pizza to eat for lunch. So that was great! I feel like he’ll be okay now and that he understands he’ll be at school all day and eat lunch with his friends. He’ll get a recess which will really help him out and Mrs. H. said that he will have sensory breaks in her classroom a couple of times per day or as needed. Thomas was pleased to hear that. When we were in his new classroom, he noticed many similarities between his kindergarten room and the first grade room which made him very happy. There was a chart on the wall for the weather, lots of numbers to count the days and the old “green-yellow-red light” cards on the wall to track everyone’s behavior.
As we walked home from school, I asked him again how he felt about it. I said, “So how do you feel about first grade now? Do you think you’ll like it?” He replied, “I think it’ll be great!” I really, REALLY hope he means it! School starts next Wednesday.
I can’t wait, for my own sake. It’s been one hell of a rough summer.


The long and winding road

Jul 4, 2009 by Anonymous

Conor is the name of my beautiful green-eyed boy who last year was formally diagnosed with autism spectrum disorder. We had been told by a teacher at his daycare that she felt he needed to be evaluated. We took him to our local school district and they agreed that he had "developmental delays." It wasn't until January of last year that his speech therapist actually uttered the word "autism" in assocation with Conor and that was the most devastating word we had probably evere heard. However, whatever we started to read about autism didn't seem to fit him completely. Conor is a very affectionate, articulate and happy little boy. There didn't seem to be any books out there to describe him in the context of having autism. That seems to be changing but it's still quite lacking. I guess I'll have to write my own book!

Nevertheless, as it turns out, loving a child with autism is not the worst thing in the world. We have been enormously blessed with the school Conor attends, where he has been for two years now. He is attending summer school now to keep up the work and not have it disrupted. He only has two more weeks left at this school and then will move to his new elementary school for kindergarten. We are trying to prepare him as best we can. We have set up meetings with his new teacher and drive by the school whenever we have an opportunity. His new school has the same cross-categorical program that his current school has so while he'll have a whole new teacher, school and routine to adjust to, he'll at least have the same program. In the morning, he'll have one-on-one work for his IEP and then in the afternoon, he'll attend regular kindergarten witih his peer group and have an assistant who will shadow him and another cross-cat student. I am excited to have him start this new school with all the possibilities it will provide. He'll be in a class with children his own age, whereas now, he's in with some kids who are a little younger than he is, whom he often imitates (i.e., screaming, hitting himself, making baby noises, etc.). His teachers are confident that he'll outgrow this tendency to imitate, which will come with maturity. We can ask him, "Hey, who are you imitating now?" and he'll respond, "Justin, Payton, Jacob, etc." So he knows he's doing it and knows it's not an entirely desirable behavior. His teachers have commented that this is upsetting to the child he's imitating so we work diligently to overcome that behavior.

 Conor has come a remarkably long way and his teachers agree. There are many things he can now do that he wasn't able to do before. Academically, he's right on track, but socially, not so much. He has a hard time making friends. We hope that he will develop better skills in kindergarten to make connections with friends and learn the appropriate ways to interact with friends. Sharing is a big hurdle!

Conor has an 18-month old sister and that has been an interesting journey. When we first brought her home from the hospital, he didn't want us to get her out of the car! He has had to learn what is appropriate behavior with her and how to be gentle. It's very disconcerting when he laughs inappropriately when she cries in distress. However, if I cry, he shows immense concern and empathy. It's pretty remarkable to witness. I think as he and his baby sister get closer and closer as they grow up together, his connection to her will be more compassionate.

Conor has been a study subject to research the low-dose effects of Risperdal in ASD children. Having him participate in this study was a very arduous and painful decision. His participation ends next month and we're not entirely sure how much it has helped him or affected his behavior positively. In fact, there seems to be an emphasis on some undesirable behaviors and we're not sure if it's environmental or biological. Who knows? All of this is such a crap shoot... everyone just wants a definitive explanation about how to heal/treat/cure autism. Lord knows I sure do! But as I have said, this I can handle. It's certainly a challenge but it's not insurmountable. My child is healthy and happy... we can work together to get him where he needs to be.


Cabin fever in June...

Jun 15, 2009 by Anonymous

Summer vacation has begun and I’m already being driven nuts by these children. These small, charming Gifts from God are making me wonder if we should move to a district that has a twelve-month school year. What’s really going on here is that Thomas and Hayley are driving each other nuts and that, in turn, is making me crazy. The root of the problem is that the weather has been so crummy (for mid-June) that we haven’t been able to do anything. If it’s warm enough to swim, it’s raining. If it’s sunny outside, it’s too cool to go swimming and all the slides at the park have big pools at the bottom. We’re still waiting and waiting for the weather to improve.
Today was actually pretty nice, but I made a grooming appointment for the dog that we had to work around. We left the groomer’s straight for Uncle Tom’s Pool and stayed there until the groomer called us to come pick up Sophie. Frantic pool and swimming activity usually works wonders on kids who have cabin-fever (in June, for crying-out-loud!) but my kids are not like other people’s kids.
We did have a few playdates a few weeks ago with the family I mentioned in my last blog. Thomas was actually really good with his buddy. I explained before they came over that he couldn’t just sit alone and play when we had “company” (what’s “company,” Mommy?) but he had to play with his friend. So, since he couldn’t play PSP, Thomas and his friend played MarioKart on the Wii. Whatever. They had fun. Hayley and her friend played Barbies and the littlest wee one just bounced back and forth, watching. Hopefully we’ll see them again soon and maybe meet at the park or something.
Graduation went fine, but of ALL DAYS for me to forget to give Thomas his Strattera, the graduation ceremony day was probably the worst. He had to sit quietly for semi-extended periods of time which didn’t work out too well for him. The video is funny because he kept waving me away, telling me to turn the camera off and go sit down. But he got an extra-special hug from Mrs. H., who I could tell was genuinely sad to have to say good-bye for the summer.
After the graduation ceremony, Thomas had just one more day of school that happened to be on Tuesday, my help-out day. So I got to be there for the last day, helping take everything off the walls and put things away for the summer. It was kind of sad. I’ve been there every Tuesday all year and have apparently built up a sentimental interest in the Kindergarten classroom and the routine. I really appreciated how much emotional investment the teachers must have in their kids by the end of the year and how hard it is for them to have to let them go. During the graduation ceremony, Mrs. H. gave a short speech about how once the kids go through her classroom for a year, they’ll always be “hers” and can come back and see her anytime. She got choked up as usual and it was very sweet. The kids all wore caps and gowns and Thomas kept pulling his up to reveal the decidedly un-formal t-shirt and shorts I put him in that day. No point making him doubly-uncomfortable in fancy pants AND mortar boards, I though. Nobody gave me any funny looks, though.
Hopefully the weather will turn better so we can walk to the park more often and maybe go to the zoo. All I know is that if we’re all cooped up in this house together for much longer, I’m going to start frantic home-improvement projects like re-painting or something. Hayley’s fifth birthday is coming up; her party is this weekend and Jonathan is apparently going to be up at 4 a.m., slow-cooking pork butts on the grill. It’s the only way, I guess. What I really want to do is get pictures of this madness. We’re going to turn the pork butts into pulled pork sandwiches made with Jonathan’s homemade BBQ sauce. He’s such a gourmand. I’m in charge of potato salad and coleslaw. And I’ll be buying beer too, I think.
We’re going to a wedding in Peoria June 26-28 and leaving the kids with Grandma Jackson. The dog’s going to my brother-in-law and sister-in-law’s house, God bless them. That’s the main reason I just had her at the vet and the groomer. Nothing says, “Gee, we sure do appreciate this” like dumping a shaggy, smelly and potentially unhealthy dog off with relatives. Jonathan and I certainly could use a break. We keep talking about taking a “date night” for ourselves, but there is just no time! This Friday, we’re going to be getting ready for Hayley’s party which is on Saturday, and I have to work on Sunday. We should be able to have some quality alone time in Peoria, if you can have quality alone time with twenty aunts and uncles, thirty cousins and their dates or spouses, your mom, dad and sisters all staying in hotel rooms nearby. We’ll have to take whatever we can get, I think. We’re going to be driving down with my sister and her husband, whose company we genuinely enjoy, so that will be fun too. Plus, I get to dress up! Yee-haw!
A couple weeks ago, Jonathan only had a half-day at work so we took the kids to see “Up” at the theater. We had never, ever taken both kids to the show before! Like so many things we’ve been doing recently, it was to be a litmus test for Thomas’ performance during stage and theater presentations at Disney. He was GREAT! Outstanding, even! He was, in fact, better behaved than Hayley. He sat in his seat and wore the 3-D glasses (yes, we sprung for the 3-D effect, but don’t think it added too much to the show. The previews were more impressive in 3-D than the movie was, so FYI, you can probably skip the 3-D showing and do the less expensive non-3-D show) and watched the WHOLE THING without complaint. The only problem was that he talked a lot during the show, asking a lot of questions, but he wasn’t too loud asking the questions and didn’t disturb others. There were plenty of children at this showing in particular that were allowed to run wild all over the place and I’m so glad to say that mine were not among them.
I’m trying to keep up with helping the kid’s reading and writing so that their brains don’t turn to mush over the summer but Thomas is totally on to me. He says, “I’m not in school anymore! I don’t have homework!” And then he finds something else to do. Hmpf. Hayley is still really interested in writing and will write words, asking how to spell them and drawing really cute pictures of people who look like potatoes with toothpicks sticking out for arms and legs. They’re really cute.
Well, there goes the random quiet moment I was able to enjoy today. Thomas is stealing noodles out of the colander and making Jonathan crazy and Hayley has fallen asleep next to me in a position that cannot possibly be comfortable. Ho-hum.


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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