Social computer games may someday be a good intervention for adolescents with autism.
Play therapy is often used to treat children with autism, but many adolescents feel themselves to be too old for play therapy. This short paper describes the use of certain types of video games as an intervention for people with autism. The author describes the field of social physics as a way of having computers see the emotions of the player. The author suggests that such video game structures could mimic the real social world.
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School Lunches for Kids with ASD
Sep 11, 2008 by AnonymousSCHOOL 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.
Close-talker
Feb 4, 2008 by AnonymousI called the neurologist last Monday and upon hearing that Thomas is waking up earlier than ever, she decided to increase the Clonidine to two pills at night. Now, he can barely get through his shower with his eyes open. We’re giving it to him a little later than 7 p.m. so that he doesn’t fall asleep too early. This medication seems to work quickly but not long-term. I have heard that there is an extended-release Clonidine and I think I’ll have to call the doctor to ask her about it.
Last Friday I had a conference with Thomas’ teacher. It’s lucky that I came early because the principal cancelled conferences due to the big snowstorm we had here beginning Friday afternoon. We had a great little talk about Thomas, who is doing so many new and interesting things. He can trace his name all by himself! He actually draws the letters – I saw a sample and she took pictures of him doing it! I was very excited to hear that. They have all the kids do it at the beginning of school every day, so I suppose that eventually they’ll just remove the letters that they trace and have the kids write their names.
Also, and this is very cute, there’s a little girl in Thomas’ class who has a crush on him! He has a little girlfriend! She started right after winter break, so she is new to the class just like Thomas was in November. The first day back from break, the kids were doing the “Freeze Dance” and Thomas asked this little girl if she wanted to dance with him – just like a couple of teenagers, but without the angst and fear of rejection. Now she hangs around with Thomas and follows him around during the school day. The teacher felt that Thomas actively seeking social interaction is a huge step in the right direction and so do we.
One thing that we both agreed Thomas needs help with is that he’s a close-talker (remember Judge Reinhold on “Seinfeld?”). He doesn’t acknowledge or understand other people’s need for personal space. He gets about four inches away from someone’s nose and asks questions or starts talking. I’ve been trying to model for him the appropriate distance there should be between two faces when a conversation is taking place. As is typical, he doesn’t understand social nuances. We continue to be grateful that he notices others and talks to them. In the meantime, he’s our little close-talker.
We talked a little bit about next year’s placement for kindergarten. Thomas’ teacher thinks that at this point, Thomas would be best-suited to spending part of the day in a MLP (that’s multiple learning placement) class and part of the day in a typical kindergarten class. Apparently, there are around thirty children in a regular class and the teacher feels that lots of kids would over-stimulate Thomas and he’d have a hard time with it. The MLP class is much smaller but very similar to the kindergarten class in terms of what they learn. There’s also the possibility of Thomas having an aide with him in the regular class. Those are our options at this point, but we’re very excited at the idea of Thomas being able to spend part of his day in a regular class with typically developing kids.
I’ve started taking Thomas with me when Hayley has dance class on Tuesday nights. He’s been asking to come with me for a while now. I explained that all we do is sit in a room and wait for Hayley to be done, but he was eager. Luckily, there’s another little girl in there to play with and last week there was a six year-old boy he played with. This boy was a little confused by Thomas’ lack of respect for the personal space, but he was actually very nice to Thomas and played with him during the entire hour. Unfortunately, the Leapster that Thomas got for his birthday already crapped out, and that thing kept him quiet and entertained for quite a while. I think we’ll have to get him another one and tether it to his wrist so that he can’t drop it anywhere…like the toilet.
We’re having our car fixed so my mom was gracious enough to lend us hers while we wait for the necessary repairs to be completed. Thomas has been very interested in the fact that Grandma’s car is sitting in the driveway, but luckily he’s not as crazy about the Camry as he is about Grandpa’s Highlander. My dad specifically lent us the sedan knowing that Thomas is completely and utterly obsessed with my Grandpa’s car. I explained that the Suburban was going to the “car doctor” to hopefully be fixed. I told them that if the “mechanic” (vocabulary!) couldn’t fix the car, we’d have to get a different one. Thomas was all for that idea. He doesn’t really understand about commerce and the exchange of money for good and services, though. Typical for his age group, but we’re still trying. Luckily, we can get the family truckster repaired. I told Thomas that the mechanic can give our car the right medicine and we’ll get it back tomorrow. He said, “Wait, wait, wait. You mean our truck is coming back? What about a new one?” I explained that we don’t have to get a new car after all and isn’t that great? He was crestfallen, apparently really hoping to get rid of that old jalopy leaking oil in the driveway. It’s so offensive to him.
About Reading and nonverbal/low-communicating people with autism
Aug 1, 2007 by dankohnIt seems likely that many if not most nonverbal or low-communicating children with autism can read by the time they are six or seven, sometimes earlier – even when no one has taught them and even when no one knows they can read. I have observed this time and again and professionals who work with nonverbal children/people with autism using literacy based methods have confirmed this observation. It is hard to imagine the concept at first - that a person could know how to read and yet not know how to communicate, but it turns out that it is probably somewhat common in this population.
Recently a member posted on my community forum (www.strangeson.com) about reading and how colorful picture books kept her child’s visual interest. I thought I would share a few thoughts on this and in particular differentiate between a child/person’s visual interest and auditory interest in books.
There are several ways a child/person you are working with can respond and relate to books. Visually stimulating types of books designed for very young children can capture visual attention and they can be fun and useful for keeping a child/person focused on a visual target (in this case the pictures in the book) and this can be used for social interaction as I will describe below.
For educational purposes on the other hand, we need to remember that many nonverbal children/people with autism are very reliant on their auditory system for learning. I remember asking Soma when I first met her, how she got the idea to read books aloud to Tito when he was little, even though he showed no outward sign of paying attention to her words much less understanding what she was reading. She called it “listening behavior” and explained that he could have left the room, but he never did. I realized when she told me that, that when my husband read Harry Potter aloud to the kids and Dov was running around the room, making sounds and stimming and acting like he was paying no attention – he never left the room either – and he could have. Most of us think that “listening behavior” consists of sitting quietly and attending to the pages of the book, but Soma taught me that not leaving the room was listening behavior too.
Later, when Dov began to communicate, it turned out he had been listening all along and he could answer all kinds of questions about Harry Potter from when his Dad used to read it aloud. You can read a few sentences or a paragraph of age-appropriate material, whether from a teen magazine or the newspaper or a book and then ask a question and use multiple choices to get the answer, then read some more. If the child/person stays in the room – you can be pretty sure he/she is listening, even if he/she displays none of the behaviors such as sitting quietly and looking at the pages.
It’s gotten to the point now that Dov knows it bothers me when he starts stimming too wildly while I am reading to him, and so when he does it I just stop reading mid-word and give him a quick look and he stops immediately – because he loves to listen to someone reading out loud! Then I resume reading immediately. Now Dov can sit for hours listening and answering questions and asking them too and I’m the one who usually tires out first.
But Dov also still loves to look at his favorite, visually exciting type of books with high contrast colors and designs, and sparkly illustrations; books for very young children. These kinds of books definitely still capture his visual attention and when he is paging through one of his favorite “visual” books, sometimes I take the opportunity to talk about the pictures with him, and discuss what he likes and why. Dov can spell out a word, phrase or sentences about the pictures in these books but in the beginning we often used multiple choice and even now, if he is tired or having a hard day, we might still use multiple choice sometimes.
An example of how you can use multiple choice with a picture book to turn visual fascination into communication, you could ask: “I see you like this page. What do you like about it?” then I quickly jot the choices on a clipboard: “the way it looks?”, “the way it feels?”, or “both” and “something else”. (I always include “something else”) If he/she chooses “the way it looks” you could ask: “What do you like about the way it looks?” and offer the choices: “the colors?”, “the sparkliness?”, and so on. You could also ask him/her to show you the part of the page he/she likes best (by pointing) and then talk about that, ask more questions, and so on. This is a fun activity and it gives you a chance to share something the child/person likes and have an interaction about it - which most kids/people with autism don’t get a chance to experience often enough. But it is also a completely different kind of activity than reading a book for the sake of learning about something and/or for the literary enjoyment.
Both kinds of activities are very valuable. Enjoy!
Best wishes, -Portia